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目的:探索24h食管pH检测对胃食管反流和胃食管反流性疾病的诊断价值。 方法:采用携带式24h食管pH分析仪对37例具有胃食管反流症状患者作为疾病组在常态下进行24h食管pH监测,并以20名健康成人作为对照组进行比较。 结果:20名正常成人中平均97.7％的时间食管pH>4,观察6项食管pH测定指标,得出95％的正常值范围:pH<4的总时间百分率为4.97％;pH<4的立位时间百分率为3.82％;pH<4的卧位总时间百分率2.34％,反流持续≥5min的次数<2.57;最长反流持续时间<18.62min,pH<4的反流次数为25.69次。疾病组与对照组相比有显著差异(P<0.01),24h食管pH监测的阳性检出率为94.59％,明显高于食管钡餐X线检查(27.02％)、内镜检查(40.54％)及食管粘膜活检(51.35％)等方法。 结论:24h食管pH监测的指标对鉴别生理性与病理性GER,深入了解GER与食管炎的关系,特别对GERD的诊断和疗效判定,提供了可靠的依据。其诊断价值明显优于食管钡餐X线检查和内镜检查。
Objective: To explore the value of 24h esophageal pH detection in the diagnosis of gastroesophageal reflux and gastroesophageal reflux disease. Methods: Thirty-seven patients with gastroesophageal reflux disease were selected as the disease group under normal conditions for 24-hour esophageal pH monitoring using a portable 24h esophageal pH analyzer. Twenty healthy adults as control group were compared. Results: The average esophageal pH of 97.7% of 20 normal adults was> 4. Six items of esophageal pH were measured and the normal range of 95% was obtained. The total time percentage of pH <4 was 4.97% Bit time percentage was 3.82%; pH <4, the percentage of total time lying in bed was 2.34%, the number of reflux for ≥5min was <2.57; the duration of longest reflux was <18.62min; the number of reflux for pH <4 was 25.69. The positive rate of esophageal pH monitoring for 24 hours was 94.59%, which was significantly higher than that of esophageal barium meal X-ray examination (27.02%), endoscopy (40.54%) and control group Esophageal mucosal biopsy (51.35%) and other methods. Conclusion: The indicators of 24h esophageal pH monitoring can differentiate between physiological and pathological GER, and further understand the relationship between GER and esophagitis, and provide a reliable basis for the diagnosis and curative effect determination of GERD. The diagnostic value was significantly better than the barium meal X-ray examination and endoscopy.