关键词:

食管测压, 食管24 h pH监测, 胃食管反流相关性胸痛, 诊断

Abstract:

Objective　To investigate the value of esophageal manometry combined with 24 h pH monitoring in the diagnosis of gastroesophageal reflux associated chest pain. Methods　One hundred and forty-five patients with chest pain suspected to be caused by gastroesophageal reflux admitted to Tongliao City Hospital from June 2017 to December 2021 were selected for esophageal manometry and 24 h esophageal pH monitoring, including 92 males and 53 females. According to whether they had gastroesophageal reflux, they were divided into a gastroesophageal reflux group and a no reflux group. The data, such as age, gender, peristaltic contraction percentage, reflux times with pH<4, and longest reflux duration, in both groups were collected. The diagnostic results of the two groups were compared by t and χ² tests. The correlations of chest pain caused by gastroesophageal reflux with the above indicators were anyazed by multivariate logistic regression analysis and receiver operating characteristic curve (ROC). Results　Among the 145 patients, 36 ones were diagnosed as gastroesophageal reflux, and the rest 109 had no reflux. Multivariate logistic regression analysis showed that the percentage of peristaltic contraction, the number of reflux with pH < 4, and the longest duration of reflux were the influencing factors of gastroesophageal reflux related chest pain (OR=3.155, 2.998, and 3.459; P=0.003, 0.012, and 0.001). According to the ROC analysis, the sensitivity and area under curve (AUC) of the combination of esophageal manometry, the number of reflux with pH < 4, and the longest duration of reflux in the prediction of gastroesophageal reflux related chest pain were higher than those predicted by each indicator alone (P=0.001, 0.001, and 0.004); the specificity of the combination had no statistical difference from that predicted by each indicator alone (P=0.852). Conclusion　Esophageal manometry combined with 24 h pH monitoring is of great significance for the diagnosis and treatment of gastroesophageal reflux related chest pain and is worthy of clinical application.

Key words:

Esophageal manometry, 24 h pH monitoring of esophagus, Gastroesophageal reflux related chest pain, Diagnosis