在患有非心脏性胸痛或非阻塞性失足症的患者中,带阻抗的门诊24小时高分辨率测量仪的额外诊断收益率
Jutta Keller1, Marek Boedler1, Dorothea Jasper1
1Department of Internal Medicine, Israelitic Hospital Hamburg, Academic Hospital University of Hamburg, Hamburg, Germany.
长时间的24小时食道高分辨率计量 (HRM) 显著改善了在患有非心脏性胸痛和消化不良的患者中食道运动障碍的诊断. 这种扩展的测量检测到比标准HRM更多的疾病,经常改变治疗计划.
科学领域:
- 胃肠病学 胃肠病学
- 食道生理学 食道生理学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 标准食道高分辨率计量 (HRM) 可能会错过非心脏性胸痛 (NCCP) 和非阻塞性失症 (NOD) 的患者间歇性失动性.
- 这些患者长期24小时HRM测量的诊断灵敏度尚未得到充分确立.
研究的目的:
- 评估与NCCP和/或NOD患者的标准HRM相比,延长24小时HRM的诊断收益率.
- 评估24小时HRM对治疗建议的影响.
主要方法:
- 75名患有NCCP和/或NOD的患者接受了标准HRM (水吞和米饭) 和24小时的门诊HRM与阻抗.
- 用芝加哥分类v3.0和适应的标准分析了食道收缩性参数.
- 通过图表审查跟踪患者的结果.
主要成果:
- 24小时HRM显著提高了性和/或超收缩性食道运动障碍的诊断,在61.3%的患者中确定它们 (p < 0.001).
- 与吞水HRM相比,米饭HRM的诊断率从10.7%增加到21.3% (p=0.039).
- 在15%的正常标准HRM患者中,24小时HRM检测到主要的运动障碍,在54%的病例中改变了治疗.
结论:
- 24小时HRM显著提高了NCCP/NOD患者食道运动障碍的诊断产量,可能是由于昼夜变化.
- 24小时HRM的发现经常影响治疗决策,尽管长期临床影响需要进一步调查.
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