在芝加哥分类协议中,评估食管胃结口屏障功能与腰直转的功能
Stefano Siboni1, Roberta De Maron1, Andrea Pasta2,3
1Division of General and Emergency Surgery, IRCCS Policlinico San Donato, Milano, University of Milan, Milan, Italy.
Neurogastroenterology and motility
|May 27, 2025
概括
仰卧直立转变 (SUT) 机动与直立腿抬起 (SLR) 相似,用于评估胃食道逆流症 (GERD) 在测量力时. 两次操作的一致结果提高了GERD诊断的米兰分数的准确性.
科学领域:
- 胃肠病学 胃肠病学
- 食道生理学 食道生理学
- 诊断力测仪的诊断力测仪
背景情况:
- 直腿抬起 (SLR) 机动评估食管胃结 (EGJ) 屏障功能在高分辨率测量 (HRM) 和是米兰分数 (MS) 的一部分.
- 芝加哥分类4.0 (CCv4.0) 协议结合了仰卧直立过渡 (SUT) 来增加腹内压力 (IAP).
研究的目的:
- 为了比较SUT和SLR机动在增加IAP中的有效性.
- 评估SUT和SLR的预测价值,用于诊断病态胃食道逆流症 (GERD).
主要方法:
- 预期招募110名患有持续性GERD症状的成年患者,接受HRM和pH阻抗.
- 在基线,SLR和SUT机动期间记录腹腔内压力 (IAP) 和食道内压力 (IEP).
- 基于酸暴露时间>6% (里昂2.0标准) 的GERD诊断.
主要成果:
- 在94%的患者中,SUT是有效的,而SLR的有效率为85%.
- 在预测GERD方面,SUT表现出较高的灵敏度 (77.4%),但比SLR更低的特异性 (63.5%), (71.0%的灵敏度,79.6%的特异性).
- 使用SUT (MS-SUT) 的米兰分数曲线下的面积 (AUC) 为0.825,使用SLR (MS-SLR) 的面积为0.854. 当两种操作一致时,米兰分数的AUC为0.872.
结论:
- 该SUT机动相当于SLR,提供更高的灵敏度,但在预测GERD时的特异性较低.
- 来自SUT和SLR机动的一致结果增加了GERD米兰分数的信心和诊断准确性.
- SUT可以作为评估EGJ屏障功能的和诊断GERD的测量力学协议的宝贵补充.
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