PDF(Pubmed)
Abstract：
This study aims to enhance the effectiveness of high resolution manometry (HRM) and pH-impedance monitoring metrics in distinguishing between gastro-esophageal reflux disease (GERD) and non-GERD. A retrospective propensity score matching (PSM) study was conducted on 643 patients with GERD symptoms. PSM matched 134 GERD patients with 134 non-GERD controls. Body mass index (BMI), intra-esophageal pressure (IEP) and intra-gastric pressure (IGP) were significantly higher in the GERD group compared to the non-GERD group. BMI was correlated with IEP and IGP positively. IGP was positively correlated with esophagogastric (EGJ) pressure (EGJ-P) in participants with EGJ type 1 and 2, but not in participants with EGJ type 3. BMI was correlated with distal MNBI negatively. Logistic regression showed BMI as an independent risk factor for GERD. Receiver operating characteristic curve (ROC) and decision curve analysis (DCA) showed that BMI adjusted EGJ contractile integral (EGJ-CI) and BMI adjusted MNBI were superior to the corresponding original ones in predicting GERD susceptibility. According to the findings, BMI and IGP are the main factors contributing to the development of GERD. BMI affects IEP through the adaptive response of EGJ-P to IGP. Incorporating BMI into the calculations of EGJ-CI and MNBI can improve their ability in predicting GERD susceptibility.
摘要：
这项研究旨在提高高分辨率测压（HRM）和pH阻抗监测指标在区分胃食管反流病（GERD）和非GERD方面的有效性。对643例有GERD症状的患者进行了回顾性倾向评分匹配（PSM）研究。PSM匹配134例GERD患者与134例非GERD对照。身体质量指数(BMI),GERD组的食管内压(IEP)和胃内压(IGP)显著高于非GERD组.BMI与IEP、IGP呈正相关。在EGJ类型1和2的参与者中，IGP与食管胃（EGJ）压力（EGJ-P）呈正相关，而在EGJ类型3的参与者中则不相关。BMI与远端MNBI呈负相关。Logistic回归显示BMI是GERD的独立危险因素。受试者工作特征曲线（ROC）和决策曲线分析（DCA）显示，BMI调整的EGJ收缩积分（EGJ-CI）和BMI调整的MNBI在预测GERD易感性方面优于相应的原始指标。根据调查结果,BMI和IGP是影响GERD发生发展的主要因素。BMI通过EGJ-P对IGP的适应性反应影响IEP。将BMI纳入EGJ-CI和MNBI的计算可以提高其预测GERD易感性的能力。
