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目的探讨含餐8h食管pH监测对胃食管反流病(GERD)的诊断意义,并以常规24hpH监测为标准验证其灵敏度及特异度。方法对2003年3月至2006年9月北京大学人民医院消化科221例患者进行食管测压和pH监测。首先由系统计算24h DeMeester积分,≥14.72分诊断为胃食管反流病。入选患者晚餐开始共计8h的监测数据,同样计算DeMeester积分,相同的标准诊断胃食管反流病。比较两种方法的一致性及积分的相关性。结果221例患者经常规24hpH监测诊断胃食管反流病124例,正常97例,含餐8hpH监测方法诊断胃食管反流病120例,正常101例。含餐8h的灵敏度为93.5%,特异度95.9%,经Kappa及Mc-nemar检验2种方法具有良好的一致性,部分结果的差异不具有显著性。2种检测方式DeMeester积分的相关系数为0.929。结论含餐8小时监测法和24hpH监测法具有良好的一致性,有望用于GERD特别是内镜阴性GERD的诊断。
Objective To investigate the diagnostic value of esophageal pH 8-hour esophageal pH monitoring on gastroesophageal reflux disease (GERD) and to verify its sensitivity and specificity by routine 24 hpH monitoring. Methods From March 2003 to September 2006 Peking University People ’s Hospital Department of Gastroenterology 221 cases of esophageal manometry and pH monitoring. First, the system calculates 24h DeMeester score, ≥ 14.72 points diagnosed as gastroesophageal reflux disease. Selected patients starting dinner for a total of 8h monitoring data, the same calculation DeMeester points, the same standard diagnosis of gastroesophageal reflux disease. Compare the consistency of the two methods and the correlation of the integrals. Results Of the 221 patients, 124 cases were routinely diagnosed with gastrointestinal reflux disease by 24 hpH and 97 patients were diagnosed as normal. Gastroesophageal reflux disease was diagnosed in 120 cases and 101 cases were normal by food 8 hpH monitoring. The sensitivity of 93.5% and 95.9% of the 8 h meals was good, and the Kappa and Mc-nemar tests showed good agreement between the two methods, and the differences of some results were not significant. The correlation coefficient of DeMeester points for the two detection methods was 0.929. Conclusion There is a good consistency between the 8-hour monitoring method and the 24hpH monitoring method, which is expected to be used in the diagnosis of GERD, especially endoscopic negative GERD.