Application of mean nocturnal baseline impedance in gastroesophageal reflux disease

doi:10.3877/cma.j.issn.2095-8765.2021.03.004

Abstract

Abstract:

Objective

To monitor the esophageal mucosal esophageal baseline impedance (BI) in patients with gastroesophageal reflux disease (GERD) and explore its value.

Methods

For 92 patients with GERD diagnosed in our hospital from March 2017 to March 2018 and undergoing upper gastrointestinal endoscopy and 24-hour esophageal impedance pH monitoring, the BI characteristics of patients with different types of GERD and refractory GERD were analyzed, and the relationship between GERD symptom score and BI were compared.

Results

Of the 92 patients, 75 were diagnosed with non-erosive reflux disease (NERD), 9 were diagnosed with erosive esophagitis (EE), and 8 were diagnosed with Barrett's esophagus. BI at 3 cm and 5 cm and distal Bi above LES in the NERD group were higher than those in the EE group. The symptom score of patients with chest pain was positively correlated with BI at 3 cm, 5 cm, and 9 cm on the LES, while the BI of patients with heartburn had no correlation with the symptom score. Bi at 3 cm, 5 cm and distal BI above LES in PPI effective group were lower than those in refractory heartburn group. The best cut-off values of BI at 3 cm and 5 cm above LES were 2369 Ω and 2936 Ω, respectively. Bi at 3 cm, 5 cm, 7 cm,and distal BI above LES in PPI effective group were lower than those in refractory chest pain group. The best cut-off values for BI at 3 cm, 5 cm, and 7 cm on the LES to distinguish the PPI effective group and refractory chest pain are 3006 Ω, 3053 Ω, and 3015 Ω, respectively.

Conclusion

BI decreased in the damaged mucosa. The chest pain symptom score of NERD patients is positively correlated with the BI value. BI can predict the efficacy of PPI, and NERD patients with higher BI values may not benefit from PPI. The best cut-off value can be used as a diagnostic index for PPI-refractory NERD patients.

Key words: gastroesophageal reflux disease, proton pump inhibitors, baseline impedance

Zhifeng Ma, Taiyang Liu, Jie Yang. Application of mean nocturnal baseline impedance in gastroesophageal reflux disease[J]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2021, 08(03): 129-135.

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Figures/Tables 7

References 24

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组别	例数	BI 17 cm	BI 15 cm	BI 9 m	BI 7 m	BI 5 m	BI 3 m	远端BI
NERD	75	2563.6±612.1	2520.7±692.3	2981.6±788.6	3034±729.1	2883.8±742.9	2587.2±845.8	2890.1±674.4
EE	9	2584.1±882.4	2534.7±992.1	2799.2±738.5	2678.2±572	2095.1±999.4	1977.8±914.1	2387.6±576.3
t值		-0.068#	-0.055	0.659	1.41	2.897	2.026	2.141
P值		0.947	0.957	0.512	0.162	0.005	0.046	0.035

组别	例数	BI 17 cm	BI 15 cm	BI 9 m	BI 7 m	BI 5 m	BI 3 m	远端BI
NERD	75	2563.6±612.1	2520.7±692.3	2981.6±788.6	3034±729.1	2883.8±742.9	2587.2±845.8	2890.1±674.4
EE	9	2584.1±882.4	2534.7±992.1	2799.2±738.5	2678.2±572	2095.1±999.4	1977.8±914.1	2387.6±576.3
t值		-0.068#	-0.055	0.659	1.41	2.897	2.026	2.141
P值		0.947	0.957	0.512	0.162	0.005	0.046	0.035

组别	例数	BI 17 cm	BI 15 cm	BI 9 m	BI 7 m	BI 5 m	BI 3 m	远端BI
PPI有效	35	2363.1±710.2	2364.5±729.4	2827.5±859.2	2760.5±798.9	2435.3±697.9	2068.5±829.7	2523.0±678.4
难治性烧心	14	2643.3±345.3	2587.7±453.7	2900.1±722.8	3010.6±588.4	2967.6±497.3	2708.3±526.1	2925.0±524.5
t值		-1.850#	-1.062	-0.279	-1.059	-2.595	-2.669	-1.988
P值		0.071	0.294	0.781	0.295	0.013	0.01	0.053

组别	例数	BI 17 cm	BI 15 cm	BI 9 m	BI 7 m	BI 5 m	BI 3 m	远端BI
PPI有效	35	2363.1±710.2	2364.5±729.4	2827.5±859.2	2760.5±798.9	2435.3±697.9	2068.5±829.7	2523.0±678.4
难治性烧心	14	2643.3±345.3	2587.7±453.7	2900.1±722.8	3010.6±588.4	2967.6±497.3	2708.3±526.1	2925.0±524.5
t值		-1.850#	-1.062	-0.279	-1.059	-2.595	-2.669	-1.988
P值		0.071	0.294	0.781	0.295	0.013	0.01	0.053

组别	例数	BI 17 cm	BI 15 cm	BI 9 m	BI 7 m	BI 5 m	BI 3 m	远端BI
PPI有效	35	2363.1±710.2	2364.5±729.4	2827.5±859.2	2760.5±798.9	2435.3±697.9	2068.5±829.7	2523.0±678.4
难治性胸痛	14	2597.4±619.8	2570.8±804.0	3019.6±638.9	3333.2±722.2	3364.4±788.8	2956.8±957.9	3240.1±650.5
t值		-1.079	-0.869	-0.756	-2.326	-4.057	-3.24	-3.38
P值		0.286	0.389	0.454	0.024	0	0.002	0.001

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