中国实用内科杂志2024，Vol.44Issue(10)：836-841,847,7.DOI:10.19538/j.nk2024100109
平均夜间基线阻抗和反流后吞咽诱导的蠕动波指数在内镜阴性烧心患者诊疗中的应用研究
Application research of mean nocturnal baseline impedance and post-reflux swallow-induced peristaltic wave index in the diagnosis and efficacy evaluation of patients with endoscopic negative heartburn
摘要
Abstract
Objective To investigate the diagnostic value of the MNBI and PSPW index in patients with endoscopy-negative heartburn and its relationship with the efficacy of PPIs.Methods High-resolution esophageal manometry,questionnaires,and multichannel 24-hour impedance-pH monitoring were selected from patients with gastroscopy suggesting that the esophageal mucosa was not broken and with typical heartburn symptoms who presented to the department of gastroenterology of the Second Affiliated Hospital of Anhui Medical University from March 2022 to July 2023.61 patients were enrolled according to the examination results,of which 20 were NERD,9 were RH and 32 were FH.The reflux indexes of the three groups were compared,and the diagnostic value of distal MNBI and PSPW indexes for FH was investigated by ROC analysis.All patients were divided into the PPI effective group(32 patients)and the ineffective group(29 patients)according to the questionnaire,and the reflux indexes of the two groups were compared,and the factors affecting the efficacy of PPI were analysed by applying bicategorical logistic regression.Results Distal MNBI and PSPW index were higher in FH group than in RH and NERD groups(P＜0.05),the distal MNBI was higher in the RH group than in the NERD group(P＜0.05);Using distal MNBI and PSPW index to diagnose FH,the area under the ROC curve was 0.743 and 0.908;the cut-off value of distal MNBI was 1981.88 Ω,the sensitivity was 43.8％,and the specificity was 100％;the cut-off value of PSPW index was 15.25％,the sensitivity was 78.1％,and the specificity was 100％.Logistic regression shows that the OR for distal MNBI in the PPI ineffective group is 1.003(P=0.011).Conclusion Distal MNBI and PSPW index can be used for a differential diagnosis of FH and RH,and distal MNBI can be an independent risk factor for ineffective PPI in patients with endoscopy-negative heartburn.关键词
平均夜间基线阻抗/反流后吞咽诱导的蠕动波/质子泵抑制剂/24 h-pH阻抗监测/烧心Key words
mean nocturnal baseline impedance/post-reflux swallow-induced peristaltic wave/proton pump inhibitor/24-hour impedance-pH monitoring/heartburn分类
医药卫生引用本文复制引用
何静静,李玥,胡祥鹏,宋莎莎,路燕,章礼久..平均夜间基线阻抗和反流后吞咽诱导的蠕动波指数在内镜阴性烧心患者诊疗中的应用研究[J].中国实用内科杂志,2024,44(10):836-841,847,7.基金项目
国家自然科学基金(81800524) （81800524）
安徽省高等学校省级教学研究项目(2020jxtd130) （2020jxtd130）
安徽医科大学校级青年科学基金(2021xkj044) （2021xkj044）
