如何更有效地诊断GERC:反思后反流吞诱导的围静电波指数和平均夜间基线阻抗
Bingxian Sha1, Wanzhen Li1, Haodong Bai1
1Department of Pulmonary and Critical Care Medicine, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.
新的阻抗参数,即逆流后吞诱导的围静电波指数 (PSPWI) 和平均夜间基线阻抗 (MNBI),在诊断胃食道逆流诱导的慢性咳 (GERC) 中表现有前途. 将PSPWI和酸暴露时间 (AET) 结合起来可以提高GERC的诊断准确性.
科学领域:
- 胃肠病学 胃肠病学
- 食道生理学 食道生理学
- 诊断医学 诊断医学 诊断医学
背景情况:
- 胃食道逆流引起的慢性咳 (GERC) 诊断可能具有挑战性.
- 新的阻抗参数,包括逆流后吞诱导的围静电波指数 (PSPWI) 和平均夜间基线阻抗 (MNBI),反映了食道功能.
- 这些参数可能有助于识别GERC.
研究的目的:
- 在疑似GERC的患者中调查PSPWI和MNBI的诊断价值.
- 将这些新参数的有效性与传统指标 (如酸暴露时间 (AET)) 进行比较.
主要方法:
- 分析了186名疑似GERC患者的多通道内阻抗-pH监测 (MII-pH) 数据.
- 评估了包括PSPWI,MNBI和AET在内的关键参数.
- 用接收器操作特征 (ROC) 曲线分析来评估诊断性能.
主要成果:
- 在PSPWI中,GERC的诊断值显著 (AUC=0.757),相当于AET.
- 结合AET (>4.4%) 和PSPWI (<39.4%) 与单独使用AET相比,改善了诊断准确性.
- MNBI (AUC=0.639) 和远端MNBI (AUC=0.624) 也显示出诊断效用.
- 结合AET或PSPWI可将非酸性GERC的错过诊断减少44%.
结论:
- PSPWI是GERC的有价值的诊断工具,其性能与AET.类似.
- 结合AET和PSPWI可以提高诊断效率,特别是在非酸性反流方面.
- MNBI和远端MNBI作为GERC的补充诊断指数.
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