异常的米兰分数和受损的食道粘膜完整性分层化 胃食道反流症 疾病严重程度
Marco Sozzi1, Stefano Siboni1, Pierfrancesco Visaggi2
1Division of General and Emergency Surgery, IRCCS Policlinico San Donato, Milano.
Annals of surgery
|May 5, 2025
概括
严重的GERD与夜间平均基线阻抗 (MNBI) 和米兰分数有关,这是关键预测指标. 在异常pH阻抗发现的患者中,米兰分数更高,有助于评估GERD严重程度.
科学领域:
- 胃肠病学 胃肠病学
- 消化系统生理学 消化系统生理学
- 消化管功能测试 消化管功能测试
背景情况:
- 胃食道逆流性疾病 (GERD) 带来了诊断挑战,因为症状可能与疾病严重程度无关.
- 高分辨率计量 (HRM) 和pH阻抗监测 (MII-pH) 对于评估反反流屏障功能至关重要.
- 米兰评分 (Milan Score) 提供了一种基于气压测量结果的GERD严重程度的定量测量.
研究的目的:
- 为了描述被诊断患有严重GERD的患者的尺度特征.
- 评估HRM参数与GERD诊断的里昂2.0标准结合的有用性.
- 开发一个预测模型,用于GERD的严重程度,使用测量力和阻抗数据.
主要方法:
- 分析了603名患有持续性GERD症状,接受HRM和MII-pH治疗的患者的国际前性数据库.
- 严重的GERD是由特定的标准定义的,包括高酸暴露时间,DeMeester评分,食道炎等级或巴雷特食道.
- 使用顺序逻辑回归来评估HRM和MII-pH变量对GERD严重性的预测值.
主要成果:
- 椎的大小和米兰分数类别被确定为GERD严重程度的独立预测指标 (分别为OR 1.28和2.92).
- 符合里昂2.0标准或严重GERD定义的患者表现出显著更高的米兰分数 (P<0.001).
- 在一个综合模型中,平均夜间基线阻抗 (MNBI) 和米兰分数类别独立预测了严重的GERD (OR 4.17和1.61,P<0.001).
结论:
- 平均夜间基线阻抗 (MNBI) 和米兰分数独立地与严重的GERD相关.
- 在异常pH阻抗发现的患者中,米兰评分显著升高,加强了其诊断价值.
- 这些发现凸显了整合力度和阻抗数据对于准确评估GERD严重性的重要性.
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