使用酸暴露时间和DeMeester评分进行长时间的酸性反流监测:两天不够
Michelle E Lee1,2, Gaurav Ghosh3, Katharine Rooney3
1Division of Gastroenterology and Hepatology, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, NY, USA. mel9145@nyp.org.
与标准的48小时测试相比,长时间的无线pH监测 (96小时) 显著增加了胃食道逆流性疾病 (GERD) 的诊断. 延长48小时以上的监测改变了25%的患者的解释,突出了其对于准确的GERD诊断的临床重要性.
科学领域:
- 胃肠病学 胃肠病学
- 医学诊断 医学诊断 医学诊断
背景情况:
- 无线食道pH值监测对于诊断GERD至关重要.
- 指南缺乏关于长期 (72/96-h) 和标准 (48-h) pH测试的好处的建议.
- 需要评估长期监测对GERD的诊断产量.
研究的目的:
- 评估长时间无线pH监测是否诊断出更多的GERD病例,而不是标准的48小时测试.
- 为了比较DeMeester得分和酸暴露时间作为GERD诊断标准.
- 评估不同监测期之间的协议.
主要方法:
- 对接受无线食道pH监测的成年患者的回顾性分析 (2018年8月 - 2021年7月).
- 主要结局:附加GERD诊断与48小时对96小时的监测.
- 二次结果:DeMeester得分与酸暴露时间,以及研究内部的协议.
主要成果:
- 96小时的监测结果显示,比48小时的测试 (分别为58.8%与40.8%和44.7%与32.4%) 产生了更多的GERD诊断 (DeMeester分数升高或酸暴露>6%).
- 超过48小时的监测导致24.8%的患者的解释发生了临床意义上的变化.
- 从第三到第四天的数据显示,只有56.6%的人同意前两天的数据.
结论:
- 扩展的pH监测在近一半的患者中发现了GERD,最初的48小时结果正常.
- 在大约25%的病例中,将监测延长到48小时之外会改变研究解释.
- 标准的48小时pH监测可能会错过临床上显著的GERD诊断.
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