PDF(Pubmed)
Abstract：
BACKGROUND: Post-reflux swallow-induced peristaltic wave index (PSPWI) and mean nocturnal baseline impedance (MNBI) are novel parameters reflect esophageal clearance capacity and mucosal integrity. They hold potential in aiding the recognition of gastroesophageal reflux-induced chronic cough (GERC). Our study aims to investigate their diagnostic value in GERC.
METHODS: This study included patients suspected GERC. General information and relevant laboratory examinations were collected, and final diagnosis were determined following guidelines for chronic cough. The parameters of multichannel intraluminal impedance-pH monitoring (MII-pH) in patients were analyzed and compared to explore their diagnostic value in GERC.
RESULTS: A total of 186 patients were enrolled in this study. The diagnostic value of PSPWI for GERC was significant, with the area under the working curve (AUC) of 0.757 and a cutoff value of 39.4%, which was not statistically different from that of acid exposure time (AET) (p > 0.05). The combined diagnostic value of AET > 4.4% and PSPWI < 39.4% was superior to using AET > 4.4% alone (p < 0.05). Additionally, MNBI and distal MNBI also contributed to the diagnosis of GERC, with AUC values of 0.639 and 0.624, respectively. AET > 4.4% or PSPWI < 39.4% is associated with a 44% reduction in missed diagnoses of non-acid GERC compared to AET > 6.0% or symptom association probability (SAP) ≥ 95%, and may be more favorable for identifying GERC.
CONCLUSIONS: The diagnostic value of PSPWI for GERC is comparable to that of AET. Combining PSPWI < 39.4% or AET > 4.4% can improve the diagnostic efficiency by reducing the risk of missed diagnoses in cases where non-acid reflux is predominant. Distal MNBI and MNBI can serve as secondary reference indices in the diagnosis of GERC.
METHODS: This study included patients suspected GERC. General information and relevant laboratory examinations were collected, and final diagnosis were determined following guidelines for chronic cough. The parameters of multichannel intraluminal impedance-pH monitoring (MII-pH) in patients were analyzed and compared to explore their diagnostic value in GERC.
RESULTS: A total of 186 patients were enrolled in this study. The diagnostic value of PSPWI for GERC was significant, with the area under the working curve (AUC) of 0.757 and a cutoff value of 39.4%, which was not statistically different from that of acid exposure time (AET) (p > 0.05). The combined diagnostic value of AET > 4.4% and PSPWI < 39.4% was superior to using AET > 4.4% alone (p < 0.05). Additionally, MNBI and distal MNBI also contributed to the diagnosis of GERC, with AUC values of 0.639 and 0.624, respectively. AET > 4.4% or PSPWI < 39.4% is associated with a 44% reduction in missed diagnoses of non-acid GERC compared to AET > 6.0% or symptom association probability (SAP) ≥ 95%, and may be more favorable for identifying GERC.
CONCLUSIONS: The diagnostic value of PSPWI for GERC is comparable to that of AET. Combining PSPWI < 39.4% or AET > 4.4% can improve the diagnostic efficiency by reducing the risk of missed diagnoses in cases where non-acid reflux is predominant. Distal MNBI and MNBI can serve as secondary reference indices in the diagnosis of GERC.
摘要：
背景：反流吞咽后引起的蠕动波指数（PSPWI）和平均夜间基线阻抗（MNBI）是反映食管清除能力和粘膜完整性的新参数。它们具有帮助识别胃食管反流引起的慢性咳嗽（GERC）的潜力。我们的研究旨在探讨它们在GERC中的诊断价值。
方法：本研究纳入疑似GERC患者。收集了一般资料和相关的实验室检查，根据慢性咳嗽指南确定最终诊断.分析并比较了患者的多通道腔内阻抗-pH监测（MII-pH）参数，以探讨其在GERC中的诊断价值。
结果：本研究共纳入186例患者。PSPWI对GERC的诊断价值显著,工作曲线下面积（AUC）为0.757，截止值为39.4%，与酸暴露时间（AET）无统计学差异（p>0.05）。AET>4.4%和PSPWI<39.4%的联合诊断价值优于单独使用AET>4.4%(p<0.05)。此外,MNBI和远端MNBI也有助于GERC的诊断，AUC值分别为0.639和0.624。与AET>6.0%或症状关联概率(SAP)≥95%相比，AET>4.4%或PSPWI<39.4%与非酸性GERC的漏诊减少44%相关。可能更有利于鉴别GERC。
结论：PSPWI对GERC的诊断价值与AET相当。结合PSPWI<39.4％或AET>4.4％可以通过降低在非酸性反流为主的情况下漏诊的风险来提高诊断效率。远端MNBI和MNBI可作为GERC诊断的次要参考指标。
方法：本研究纳入疑似GERC患者。收集了一般资料和相关的实验室检查，根据慢性咳嗽指南确定最终诊断.分析并比较了患者的多通道腔内阻抗-pH监测（MII-pH）参数，以探讨其在GERC中的诊断价值。
结果：本研究共纳入186例患者。PSPWI对GERC的诊断价值显著,工作曲线下面积（AUC）为0.757，截止值为39.4%，与酸暴露时间（AET）无统计学差异（p>0.05）。AET>4.4%和PSPWI<39.4%的联合诊断价值优于单独使用AET>4.4%(p<0.05)。此外,MNBI和远端MNBI也有助于GERC的诊断，AUC值分别为0.639和0.624。与AET>6.0%或症状关联概率(SAP)≥95%相比，AET>4.4%或PSPWI<39.4%与非酸性GERC的漏诊减少44%相关。可能更有利于鉴别GERC。
结论：PSPWI对GERC的诊断价值与AET相当。结合PSPWI<39.4％或AET>4.4％可以通过降低在非酸性反流为主的情况下漏诊的风险来提高诊断效率。远端MNBI和MNBI可作为GERC诊断的次要参考指标。
