PDF(Pubmed)
Abstract：
The Lyon Consensus provides conclusive criteria for and against the diagnosis of gastro-oesophageal reflux disease (GERD), and adjunctive metrics that consolidate or refute GERD diagnosis when primary criteria are borderline or inconclusive. An international core and working group was assembled to evaluate research since publication of the original Lyon Consensus, and to vote on statements collaboratively developed to update criteria. The Lyon Consensus 2.0 provides a modern definition of actionable GERD, where evidence from oesophageal testing supports revising, escalating or personalising GERD management for the symptomatic patient. Symptoms that have a high versus low likelihood of relationship to reflux episodes are described. Unproven versus proven GERD define diagnostic strategies and testing options. Patients with no prior GERD evidence (unproven GERD) are studied using prolonged wireless pH monitoring or catheter-based pH or pH-monitoring off antisecretory medication, while patients with conclusive GERD evidence (proven GERD) and persisting symptoms are evaluated using pH-impedance monitoring while on optimised antisecretory therapy. The major changes from the original Lyon Consensus criteria include establishment of Los Angeles grade B oesophagitis as conclusive GERD evidence, description of metrics and thresholds to be used with prolonged wireless pH monitoring, and inclusion of parameters useful in diagnosis of refractory GERD when testing is performed on antisecretory therapy in proven GERD. Criteria that have not performed well in the diagnosis of actionable GERD have been retired. Personalisation of investigation and management to each patient\'s unique presentation will optimise GERD diagnosis and management.
摘要：
里昂共识为胃食管反流病（GERD）的诊断提供了结论性标准，和辅助指标，巩固或反驳GERD诊断时，主要标准是边界或不确定的。自最初的里昂共识发表以来，组建了一个国际核心和工作组来评估研究，并对为更新标准而共同开发的声明进行投票。里昂共识2.0提供了可操作GERD的现代定义，食道测试的证据支持修改，对有症状的患者逐步升级或个性化GERD管理。描述了与反流发作有关的可能性高和低的症状。未经验证的GERD定义了诊断策略和测试选项。没有GERD证据（未经证实的GERD）的患者使用延长的无线pH监测或基于导管的pH或不使用抗分泌药物的pH监测进行研究。而具有决定性GERD证据（经证实的GERD）和持续症状的患者在接受优化的抗分泌治疗时使用pH-阻抗监测进行评估。与原始里昂共识标准的主要变化包括将洛杉矶B级食管炎确立为决定性的GERD证据，用于长期无线pH监测的指标和阈值的描述，以及在已证实的GERD中对抗分泌疗法进行测试时，纳入对诊断难治性GERD有用的参数。在可操作的GERD的诊断中表现不佳的标准已经退役。个性化的调查和管理对每个患者的独特表现将优化GERD的诊断和管理。
