目的探讨24 h 咽喉 pH 检测在咽喉反流性疾病诊断中的价值。方法选取2006年8月至10月于北京同仁医院就诊由同一医师诊断可疑有反流性咽喉炎患者50例,征得患者同意后以就诊时间为配伍因素,按区组随机排列方法采用半随机分组。第一组25例...目的探讨24 h 咽喉 pH 检测在咽喉反流性疾病诊断中的价值。方法选取2006年8月至10月于北京同仁医院就诊由同一医师诊断可疑有反流性咽喉炎患者50例,征得患者同意后以就诊时间为配伍因素,按区组随机排列方法采用半随机分组。第一组25例患者均行24 h 咽喉 pH检测,筛选出阳性患者作为试验组接受奥美拉唑抗酸治疗;第二组25例患者直接给予相同药物及剂量的试验性抗酸治疗作为对照组。服药3个月后进行随访,根据反流症状评分对比治疗前后效果,以主观症状评估总分下降≤4分为治疗无效,>4分为有效。结果行24 h 咽喉 pH 检测的25例患者中有病理性咽喉部反流者17例,阳性率为68.0%(17/25)。24 h 平均总反流次数(35.71±41.70)次(±s,以下同),总反流时间(35.71±33.19)min,总反流指数即每小时反流次数(1.53±1.73)次/h,每次反流平均时间(1.12±0.91)min。抗酸治疗前试验组症状评估总分平均(14.88±4.11)分,对照组总分平均(13.00±4.17)分,组间差异采用 t 检验,无统计学意义(P>0.05)。在抗酸治疗3个月后随访,试验组有效率为82.4%(14/17),对照组失访2例,其余患者治疗有效率为52.2%(12/23)。试验组症状评估总分平均下降(7.47±3.18)分,对照组症状评估总分下降(3.96±4.25)分,总分差值比较,差异有统计学意义(P<0.01)。结论 24 h 咽喉 pH 检测作为诊断咽喉反流性疾病的金标准,可以作为临床中可疑咽喉反流患者的确诊检查手段,并可大大提高抗酸治疗的有效性,值得在临床普遍开展和推广。展开更多
AIM: To assess the diagnostic value of a combination of continuous intragastric pH and bilirubin monitoring in the detection of duodenogastric reflux (DGR), and the effects of diet on the bilirubin absorbance. METHODS...AIM: To assess the diagnostic value of a combination of continuous intragastric pH and bilirubin monitoring in the detection of duodenogastric reflux (DGR), and the effects of diet on the bilirubin absorbance. METHODS: 30 healthy volunteers were divided into two groups: standard diet group (Group 1) 18 cases, free diet group (Group 2)12 cases. Each subjects were subjected to simultaneous 24-hour intragastric pH and spectrophotometric bilirubin concentration monitoring (Bilitec 2000). RESULTS: There was no difference of preprandial phase bilirubin absorbance between two groups. The absorbance of postprandial phase was significantly increased in group 2 than group 1. There was no difference between preprandial phase and postprandial phase absorbance in group 1. Postprandial phase absorbance was significantly higher in group 2. In a comparison of bile reflux with intragastric pH during night time, there were 4 types of reflux: Simultaneous increase in absorbance and pH in only 19.6%, increase in bilirubin with unchanged pH 33.3%, pH increase with unchanged absorbance 36.3%, and both unchanged in 10.8%. Linear regression analysis showed no correlation between percentage total time of pH【4 and percentage total time of absorbance】0.14, r=0.068 P【0.05. CONCLUSION: Because of the dietary effect, high absorbance fluids or foods should be avoided in detection. Intragastric pH and bilirubin monitoring separately predict the presence of duodenal (and/or pancreatic) reflux and bile reflux. They can not substitute for each other. The detection of DGR is improved if the two parameters are combined simultaneously.展开更多
文摘目的探讨24 h 咽喉 pH 检测在咽喉反流性疾病诊断中的价值。方法选取2006年8月至10月于北京同仁医院就诊由同一医师诊断可疑有反流性咽喉炎患者50例,征得患者同意后以就诊时间为配伍因素,按区组随机排列方法采用半随机分组。第一组25例患者均行24 h 咽喉 pH检测,筛选出阳性患者作为试验组接受奥美拉唑抗酸治疗;第二组25例患者直接给予相同药物及剂量的试验性抗酸治疗作为对照组。服药3个月后进行随访,根据反流症状评分对比治疗前后效果,以主观症状评估总分下降≤4分为治疗无效,>4分为有效。结果行24 h 咽喉 pH 检测的25例患者中有病理性咽喉部反流者17例,阳性率为68.0%(17/25)。24 h 平均总反流次数(35.71±41.70)次(±s,以下同),总反流时间(35.71±33.19)min,总反流指数即每小时反流次数(1.53±1.73)次/h,每次反流平均时间(1.12±0.91)min。抗酸治疗前试验组症状评估总分平均(14.88±4.11)分,对照组总分平均(13.00±4.17)分,组间差异采用 t 检验,无统计学意义(P>0.05)。在抗酸治疗3个月后随访,试验组有效率为82.4%(14/17),对照组失访2例,其余患者治疗有效率为52.2%(12/23)。试验组症状评估总分平均下降(7.47±3.18)分,对照组症状评估总分下降(3.96±4.25)分,总分差值比较,差异有统计学意义(P<0.01)。结论 24 h 咽喉 pH 检测作为诊断咽喉反流性疾病的金标准,可以作为临床中可疑咽喉反流患者的确诊检查手段,并可大大提高抗酸治疗的有效性,值得在临床普遍开展和推广。
基金the Public Health Ministry Foundation of China,No.06-9602-13
文摘AIM: To assess the diagnostic value of a combination of continuous intragastric pH and bilirubin monitoring in the detection of duodenogastric reflux (DGR), and the effects of diet on the bilirubin absorbance. METHODS: 30 healthy volunteers were divided into two groups: standard diet group (Group 1) 18 cases, free diet group (Group 2)12 cases. Each subjects were subjected to simultaneous 24-hour intragastric pH and spectrophotometric bilirubin concentration monitoring (Bilitec 2000). RESULTS: There was no difference of preprandial phase bilirubin absorbance between two groups. The absorbance of postprandial phase was significantly increased in group 2 than group 1. There was no difference between preprandial phase and postprandial phase absorbance in group 1. Postprandial phase absorbance was significantly higher in group 2. In a comparison of bile reflux with intragastric pH during night time, there were 4 types of reflux: Simultaneous increase in absorbance and pH in only 19.6%, increase in bilirubin with unchanged pH 33.3%, pH increase with unchanged absorbance 36.3%, and both unchanged in 10.8%. Linear regression analysis showed no correlation between percentage total time of pH【4 and percentage total time of absorbance】0.14, r=0.068 P【0.05. CONCLUSION: Because of the dietary effect, high absorbance fluids or foods should be avoided in detection. Intragastric pH and bilirubin monitoring separately predict the presence of duodenal (and/or pancreatic) reflux and bile reflux. They can not substitute for each other. The detection of DGR is improved if the two parameters are combined simultaneously.
