改善了反流过敏症的诊断
Theodoros Voulgaris1, Shintaro Hoshino1, Daniel Sifrim1
1Barts and The London School of Medicine and Dentistry, Upper GI Physiology Unit Royal London Hospital, Wingate Institute of Neurogastroenterology, Blizard Institute, Queen Mary University of London, London, UK.
反流过敏 (RH) 诊断需要症状关联概率 (SAP) 和症状指数 (SI) 的一致性. 严格的RH定义更好地区分它与功能性胃灼热,帮助临床诊断.
科学领域:
- 胃肠病学 胃肠病学
- 消化系统健康 消化系统健康
- 食道疾病 食道疾病
背景情况:
- 反流过敏症 (RH) 涉及正常的酸暴露,但与反流的症状相关.
- 目前的诊断使用症状指数 (SI) 和/或症状关联概率 (SAP),尽管专家意见赞成两者的一致性.
- 这项研究研究了基于SI/SAP对应的RH患者的差异.
研究的目的:
- 评估反流过敏 (RH) 和没有反流过敏 (RH) 的患者之间的差异,重点关注症状指数 (SI) 和症状关联概率 (SAP) 的一致性.
- 评估RH不同标准的诊断效用,包括确定的 (SI和SAP均为阳性) 与不确定的 (只有一个阳性).
- 为了比较RH亚型和功能性胃灼热 (FH) 之间的PPI响应和阻抗参数.
主要方法:
- 包括2659名患有典型的反流症状的患者,同时接受PPI的pH阻抗和高分辨率计量.
- 评估患者对质子抑制剂 (PPI) 的反应.
- 将RH分类为确定的 (SI和SAP阳性) 或不确定的 (SI或SAP阳性).
主要成果:
- 在29.3%的患者中诊断出RH (确定的:14.3%,不确定的:15%).
- 确定的RH患者表现出增加的反流时间,反流发作和间歇性 Hernia 长度,而非确定的RH患者则表现出增加的反流时间,反流发作和间歇性 Hernia 长度.
- 确定的RH患者的PPI反应率明显高于功能性胃灼热 (FH) 患者.
结论:
- 质子抑制剂 (PPI) 响应在RH和FH中都是常见的,仅基于SI和/或SAP阳性,限制了其在RH诊断中的临床歧视力.
- 具有RH和SI/SAP一致性的患者与没有一致性的患者有显著差异.
- 建议采用严格的RH定义,要求SI和SAP正值,以便更好地与FH区分.
更多相关视频
08:25Construction of a Wireless-Enabled Endoscopically Implantable Sensor for pH Monitoring with Zero-Bias Schottky Diode-based Receiver
Published on: August 27, 2021
05:58Testing Acetylcholine Followed by Adenosine for Invasive Diagnosis of Coronary Vasomotor Disorders
Published on: February 3, 2021
相关概念视频
Gastroesophageal Reflux Disease II: Clinical Features and Management
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
Gastroesophageal Reflux Disease I: Meaning and Pathophysiology
Barrett Esophagus-II: Clinical Manifestations and Management
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
Gastritis III: Clinical Manifestations and Management
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
