切换至 "中华医学电子期刊资源库"

中华胃食管反流病电子杂志 ›› 2020, Vol. 07 ›› Issue (02) : 98 -104. doi: 10.3877/cma.j.issn.2095-8765.2020.02.006

所属专题: 文献

综述

食管粘膜阻抗在诊断胃食管反流病的意义
丁文京1,()   
  1. 1. 408400 重庆金佛山高等研究院人体微生态研究中心(特色生物资源研究与利用川渝共建重点实验室)
  • 收稿日期:2020-02-13 出版日期:2020-05-15
  • 通信作者: 丁文京

Value of esophageal mucosal impedance of gastroesophageal reflux disease diagnosis

Wenjing Ding1,()   

  1. 1. Human Microecology Research Center of Chongqing Jinfoshan Advanced Research Institute, Chongqing 408400, China
  • Received:2020-02-13 Published:2020-05-15
  • Corresponding author: Wenjing Ding
  • About author:
    Corresponding author: Ding Wenjing Email:
引用本文:

丁文京. 食管粘膜阻抗在诊断胃食管反流病的意义[J/OL]. 中华胃食管反流病电子杂志, 2020, 07(02): 98-104.

Wenjing Ding. Value of esophageal mucosal impedance of gastroesophageal reflux disease diagnosis[J/OL]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2020, 07(02): 98-104.

胃食管反流病(GERD)是一种复杂的疾病,具有异质的症状特征和多方面的致病基础。食管粘膜阻抗是反流的标志。受损的食管粘膜完整性在引起GERD症状中起作用。测量了沿食道的粘膜阻抗的变化程度,可用于诊断GERD患者反流对食管粘膜造成的影响。使用食管多通道腔内阻抗pH实验测量食管基线阻抗被认为是检查食管粘膜完整性研究的替代技术,有助于鉴别GERD与非GERD。内镜引导下粘膜阻抗试验是一项新技术,它利用一根直视导管接触食管内壁,以确定慢性胃十二指肠内容物引起的上皮细胞变化。这个测试本质上是测量食管上皮细胞对电流的传导能力。慢性GERD患者的食管上皮细胞改变,细胞间的间隙扩大和长期处于湿润状态,导致高导电性和低粘膜阻抗。内窥镜检查指导下的粘膜阻抗和粘膜导纳的实时测量可能有助于估计粘膜完整性,并可能以类似于24 h食管多通道腔内阻抗pH监测的方式成为GERD患者的有用诊断工具。

gastroesophageal reflux disease (GERD) is a complex disease with heterogeneous symptoms and various pathogenic mechanisms. Esophageal mucosal impedance is a sign of reflux. Impaired esophageal mucosal integrity plays a role in the development of GERD symptoms. It can be used to diagnose the effect of reflux on esophageal mucosa in GERD patients. The measurement of esophageal baseline impedance using multi-channel intraluminal impedance pH test is considered to be an alternative technique for the study of esophageal mucosal integrity, which helps to differentiate GERD from Non-GERD related conditions. Endoscopic guided mucosal impedance test (EMT) is a new technique that uses an open-ended catheter to contact the inner wall of the esophagus to determine the changes in epithelial cells caused by chronic gastroduodenal contents. This test essentially measures the ability of esophageal epithelial cells to conduct electricity. In patients with chronic GERD, esophageal epithelial cell changes, enlarged intercellular space and long-term moist state lead to high electrical conductivity and low mucosal impedance. Real time measurement of mucosal impedance and mucosal admittance guided by endoscopy may help to estimate mucosal integrity and may be a useful diagnostic tool for GERD patients in a manner similar to 24-hour esophageal multichannel impedance pH monitoring.

1
Ang D, Lee YY, Clarke JO, et al. Diagnosis of Gastroesophageal Reflux: An Update on Current and Emerging Modalities. Ann N Y Acad Sci. 2020 May 19.
2
Naik RD, Evers L, and Vaezi MF. Advances in the Diagnosis and Treatment of GERD: New Tricks for an Old Disease. Curr Treat Options Gastroenterol. 2019 Mar; 17(1):1-17.
3
Ates F, Yuksel ES, Higginbotham T, Mucosal Impedance Discriminates GERD From non-GERD Conditions. Gastroenterology. 2015 Feb;148(2):334-43.
4
Patel DA, Higginbotham T, Slaughter JC, et al. Development and Validation of a Mucosal Impedance Contour Analysis System to Distinguish Esophageal Disorders. Gastroenterology. 2019 May;156(6):1617-1626.e1.
5
Matsumura T, Arai M, Ishigami H, et al. Evaluation of Esophageal Mucosal Integrity in Patients With Gastroesophageal Reflux Disease. Digestion. 2018;97(1):31-37.
6
Matsumura MF and Choksi Y. Mucosal Impedance: A New Way To Diagnose Reflux Disease and How It Could Change Your Practice. Am J Gastroenterol. 2017 Jan; 112(1):4-7.
7
Gyawali CP, Kahrilas PJ, Savarino E, et al. Modern diagnosis of GERD: the Lyon Consensus. Gut. 2018 Jul; 67(7):1351-1362.
8
Yuksel ES, Higginbotham T, Slaughter JC, et al. Use of Direct, Endoscopic-Guided Measurements of Mucosal Impedance in Diagnosis of Gastroesophageal Reflux Disease. Clin Gastroenterol Hepatol. 2012 Oct; 10(10):1110-6.
9
Kia L, Pandolfino JE, Kahrilas PJ. Biomarkers of Reflux Disease. Clin Gastroenterol Hepatol. 2016 Jun; 14(6):790-797.
10
Zhang M, Pandolfino JE, Zhou X, et al. Assessing Different Diagnostic Tests for Gastroesophageal Reflux Disease: A Systematic Review and Network Meta-Analysis. Therap Adv Gastroenterol. 2019 Nov 21;12:1756284819890537.
11
Vaezi MF. Diagnosing Gastroesophageal Reflux Disease With Endoscopic-Guided Mucosal Impedance. Gastroenterol Hepatol (N Y). 2016 Apr; 12(4):266-8.
12
Kavitt RT, Lal P, Yuksel ES, et al. Esophageal Mucosal Impedance Pattern Is Distinct in Patients With Extraesophageal Reflux Symptoms and Pathologic Acid Reflux. J Voice. 2017 May;31(3):347-351.
13
Choksi Y, Lal P, Slaughter JC, Esophageal Mucosal Impedance Patterns Discriminate Patients With Eosinophilic Esophagitis From Patients With GERD. Clin Gastroenterol Hepatol. 2018 May;16(5):664-671.e1.
14
Patel DA and Vaezi MF. Utility of Esophageal Mucosal Impedance as a Diagnostic Test for Esophageal Disease. Curr Opin Gastroenterol. 2017 Jul; 33(4):277-284.
15
Barrett C, Choksi Y, and Vaezi MF. Mucosal Impedance: A New Approach to Diagnosing Gastroesophageal Reflux Disease and Eosinophilic Esophagitis. Curr Gastroenterol Rep. 2018 Jun 9;20(7):33.
16
Lei WY, Vaezi MF, Naik RD, Chen CL. Mucosal Impedance Testing: A New Diagnostic Testing in Gastroesophageal Reflux Disease. J Formos Med Assoc. 2019 Sep 18; S0929-6646(19)30146-9.
17
Hirano I. Role of Advanced Diagnostics for Eosinophilic Esophagitis. Dig Dis. 2014;32(1-2):78-83.
18
Lowry MA, Vaezi MF, Correa H, et al. Mucosal Impedance Measurements Differentiate Pediatric Patients With Active Versus Inactive Eosinophilic Esophagitis. J Pediatr Gastroenterol Nutr. 2018 Aug; 67(2):198-203.
[1] 邢益民, 张天飞, 戴慧勇. 胃肠充盈超声造影检查在反酸、嗳气患者临床诊断中的应用[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(03): 303-306.
[2] 李海云, 赵敏娴, 申英末, 杨慧琪. 胃底折叠术预防食管裂孔疝术后并发症的研究进展[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(05): 485-490.
[3] 玉素江·图荪托合提, 韩琦, 麦麦提艾力·麦麦提明, 黄旭东, 王浩, 克力木·阿不都热依木, 艾克拜尔·艾力. 腹腔镜袖状胃切除或联合食管裂孔疝修补术对肥胖症合并胃食管反流病的中期疗效分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(05): 501-506.
[4] 任传富, 杨志, 徐恩, 何梓芸, 罗板鑫, 陈新, 夏雪峰. 腹腔镜疝修补术联合胃底折叠术治疗食管裂孔疝合并胃食管反流病40 例临床分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(05): 507-511.
[5] 胡志伟, 吴继敏, 汪忠镐, 张美光. 胃食管反流病食管外症状抗反流手术适应证及术前评估[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(03): 241-246.
[6] 胡志伟, 吴继敏, 邓昌荣, 战秀岚, 纪涛, 王峰, 田书瑞, 陈冬, 张玉, 刘健男, 宋庆. 抗反流黏膜套扎治疗顽固性胃食管反流病[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(04): 227-233.
[7] 孙武青, 郭震, 郝少龙, 孙海涛, 姬阆, 白日星, 韩威. LSG中保留胃窦部及His角完整性对术后胃食管反流病的影响[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(02): 95-99.
[8] 唐小久, 胡曼, 许必君, 肖亚. 肥胖合并胃食管反流病患者严重程度与其焦虑抑郁及营养状态的相关性研究[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(04): 360-364.
[9] 高训锋, 许晓露, 张金辉, 蔡理全, 张恒, 邰沁文. 胃食管反流病与肝胆胰系统疾病的因果关系:一项孟德尔随机化研究[J/OL]. 中华胃食管反流病电子杂志, 2024, 11(03): 143-152.
[10] 文明, 张丽, 谢芳, 艾克拜尔·艾力, 克力木·阿不都热依木. 构建胃食管反流病患者发生心房颤动的临床预测模型[J/OL]. 中华胃食管反流病电子杂志, 2024, 11(03): 130-136.
[11] 华丽, 仲卫冬, 胡根, 张丽英, 邵国益. 手术治疗胃食管反流病对患者生活质量和心理状态影响的研究[J/OL]. 中华胃食管反流病电子杂志, 2024, 11(03): 126-129.
[12] 张靖, 柏君, 陈玉盟, 张鹏, 侯芳芳, 王军芳, 孙静, 赵士博, 杨喆, 张玥, 张瑞芳, 朱宏斌. 抗反流黏膜消融术治疗胃食管反流病患者的临床疗效[J/OL]. 中华胃食管反流病电子杂志, 2024, 11(03): 121-125.
[13] 张静, 白亦冰, 来要良, 刘永, 和媛媛, 苏敏. 不同体位对胃食管反流病患者食管高分辨率测压的影响[J/OL]. 中华胃食管反流病电子杂志, 2024, 11(03): 115-120.
[14] 刘虎, 任振, 韦笑韩, 潘晨, 吴立胜. 胃食管反流伴食管运动障碍的诊疗进展[J/OL]. 中华胃食管反流病电子杂志, 2024, 11(03): 153-158.
[15] 中国医师协会外科医师分会肥胖和代谢病外科专家工作组, 中国医师协会外科医师分会胃食管反流疾病诊疗外科专家工作组, 日本肥胖治疗学会, 韩国减重与代谢外科学会. 袖状胃切除术患者胃食管反流病诊治专家共识(2024版)[J/OL]. 中华肥胖与代谢病电子杂志, 2024, 10(03): 145-162.
阅读次数
全文


摘要