Abstract：
OBJECTIVE: We aimed to evaluate the treatment outcomes of proton-pump inhibitors (PPIs) in patients with contact granuloma (CG) and to investigate the parameters of 24 h combined dual channel pH/impedance (24 h pH/MII) monitoring, which are reliable for predicting the response to PPI of CG patients.
METHODS: We reviewed the medical records of patients with CG who had been treated with PPIs and had completed more than 6 months of follow-up. We classified the patients into two groups (cured vs. persistent), according to their PPI treatment outcomes. Reflux events were categorized into three groups based on pharyngeal pH during reflux: 1) acid reflux (pH < 4), 2) weak acid reflux (4 < pH < 7), and 3) weak alkaline reflux (pH >7), as detected by a proximal probe. We compared the results of 24h-pH/MII between the two groups and used receiver operating characteristic curve (ROC) analysis to determine the cutoff values of significant parameters for predicting responses to PPIs.
RESULTS: Among 22 patients who completed at least 6 months of PPI treatment and follow-up, weak acid reflux events were more frequently observed in persistent group than in the cured group (p = 0.046), and the proportion of weak acid reflux was also higher in the persistent group (p = 0.031) than in the cured group. Reliable parameters predictive of a poor response to PPIs were a number of weak acid reflux events ≥ 11 (area under the curve [AUC], 0.775; p = 0.03) and a proportion of weak acid reflux events ≥ 56.7 % (AUC, 0.763; p = 0.038) in ROC analyses.
CONCLUSIONS: Weak acid reflux was identified as a significant factor associated with the treatment outcomes of PPIs in patients with CG. A number of weak acid reflux events ≥ 11 is considered to be the most reliable predictor of a poor response to PPIs in patients with CG.
METHODS: We reviewed the medical records of patients with CG who had been treated with PPIs and had completed more than 6 months of follow-up. We classified the patients into two groups (cured vs. persistent), according to their PPI treatment outcomes. Reflux events were categorized into three groups based on pharyngeal pH during reflux: 1) acid reflux (pH < 4), 2) weak acid reflux (4 < pH < 7), and 3) weak alkaline reflux (pH >7), as detected by a proximal probe. We compared the results of 24h-pH/MII between the two groups and used receiver operating characteristic curve (ROC) analysis to determine the cutoff values of significant parameters for predicting responses to PPIs.
RESULTS: Among 22 patients who completed at least 6 months of PPI treatment and follow-up, weak acid reflux events were more frequently observed in persistent group than in the cured group (p = 0.046), and the proportion of weak acid reflux was also higher in the persistent group (p = 0.031) than in the cured group. Reliable parameters predictive of a poor response to PPIs were a number of weak acid reflux events ≥ 11 (area under the curve [AUC], 0.775; p = 0.03) and a proportion of weak acid reflux events ≥ 56.7 % (AUC, 0.763; p = 0.038) in ROC analyses.
CONCLUSIONS: Weak acid reflux was identified as a significant factor associated with the treatment outcomes of PPIs in patients with CG. A number of weak acid reflux events ≥ 11 is considered to be the most reliable predictor of a poor response to PPIs in patients with CG.
摘要：
目的：我们旨在评估质子泵抑制剂（PPI）对接触性肉芽肿（CG）患者的治疗结果，并研究24h双通道pH/阻抗（24hpH/MII）联合监测的参数。这对于预测CG患者对PPI的反应是可靠的。
方法：我们回顾了接受PPI治疗并完成6个月以上随访的CG患者的病历。我们将患者分为两组(治愈与persistent),根据他们的PPI治疗结果。根据回流期间的咽部pH将回流事件分为三组:1)酸回流(pH<4),2）弱酸回流（47)，由近端探针检测到。我们比较了两组之间24h-pH/MII的结果，并使用受试者工作特征曲线（ROC）分析来确定用于预测PPI响应的重要参数的截止值。
结果：在完成至少6个月PPI治疗和随访的22名患者中，弱酸反流事件在持续组中比在治愈组中更常见(p=0.046),持续组弱酸反流的比例也高于治愈组（p=0.031）。预测对PPI反应不良的可靠参数是许多弱酸反流事件≥11（曲线下面积[AUC]，0.775；p=0.03）和弱酸反流事件的比例≥56.7％（AUC，0.763；p=0.038）在ROC分析中。
结论：弱酸反流被认为是与CG患者PPIs治疗结果相关的重要因素。许多弱酸反流事件≥11被认为是CG患者对PPI反应不良的最可靠预测指标。
方法：我们回顾了接受PPI治疗并完成6个月以上随访的CG患者的病历。我们将患者分为两组(治愈与persistent),根据他们的PPI治疗结果。根据回流期间的咽部pH将回流事件分为三组:1)酸回流(pH<4),2）弱酸回流（4
结果：在完成至少6个月PPI治疗和随访的22名患者中，弱酸反流事件在持续组中比在治愈组中更常见(p=0.046),持续组弱酸反流的比例也高于治愈组（p=0.031）。预测对PPI反应不良的可靠参数是许多弱酸反流事件≥11（曲线下面积[AUC]，0.775；p=0.03）和弱酸反流事件的比例≥56.7％（AUC，0.763；p=0.038）在ROC分析中。
结论：弱酸反流被认为是与CG患者PPIs治疗结果相关的重要因素。许多弱酸反流事件≥11被认为是CG患者对PPI反应不良的最可靠预测指标。
