Analysis and comparison of impedance-pH monitoring parameters in diagnosis of GERD based on the "Lyon Consensus"

ZHANG Jing; WANG Zhifeng; KE Meiyun; FANG Xiucai; LI Xiaoqing; ZHANG Jiachang; SHU Ke; SUN Xiaohong

doi:10.16766/j.cnki.issn.1674-4152.003407

Volume 22 Issue 3

Mar. 2024

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Article Navigation > Chinese Journal of General Practice > 2024 > 22(3): 380-383

ZHANG Jing, WANG Zhifeng, KE Meiyun, FANG Xiucai, LI Xiaoqing, ZHANG Jiachang, SHU Ke, SUN Xiaohong. Analysis and comparison of impedance-pH monitoring parameters in diagnosis of GERD based on the 'Lyon Consensus'[J]. Chinese Journal of General Practice, 2024, 22(3): 380-383. doi: 10.16766/j.cnki.issn.1674-4152.003407

Citation:

ZHANG Jing, WANG Zhifeng, KE Meiyun, FANG Xiucai, LI Xiaoqing, ZHANG Jiachang, SHU Ke, SUN Xiaohong. Analysis and comparison of impedance-pH monitoring parameters in diagnosis of GERD based on the "Lyon Consensus"[J]. Chinese Journal of General Practice, 2024, 22(3): 380-383. doi: 10.16766/j.cnki.issn.1674-4152.003407

Citation:

ZHANG Jing, WANG Zhifeng, KE Meiyun, FANG Xiucai, LI Xiaoqing, ZHANG Jiachang, SHU Ke, SUN Xiaohong. Analysis and comparison of impedance-pH monitoring parameters in diagnosis of GERD based on the "Lyon Consensus"[J]. Chinese Journal of General Practice, 2024, 22(3): 380-383. doi: 10.16766/j.cnki.issn.1674-4152.003407

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Analysis and comparison of impedance-pH monitoring parameters in diagnosis of GERD based on the "Lyon Consensus"

doi: 10.16766/j.cnki.issn.1674-4152.003407

ZHANG Jing^{1, 2}
, WANG Zhifeng¹
, KE Meiyun¹
, FANG Xiucai¹
, LI Xiaoqing¹
, ZHANG Jiachang^{1, 3}
, SHU Ke^{1, 4}
, SUN Xiaohong^{1, 5
,
,}

1.
Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China

Funds:

2018YFC2000300

2022-PUMCH-B-132

Received Date: 2023-06-06
Available Online: 2024-05-27

Abstract

Abstract

Objective This study retrospectively reanalyzed the reflux parameters of patients with gastroesophageal reflux disease (GERD) detected through esophageal pH and impedance pH monitoring, following the "Lyon Consensus". The DeMeester scores (DMS) were compared to the acid exposure time (AET). Methods This study included a total of 1 023 GERD patients who underwent 24-hour esophageal pH monitoring or impedance pH monitoring at the Gastrointestinal Dynamics Center of Peking Union Medical College Hospital from January 2008 to December 2022. The reflux parameters were reanalyzed and compared using DMS and AET, respectively. Results (1) According to the "Lyon Consensus", AET demonstrates 94.7% sensitivity and 99.0% specificity, while DMS shows 98.1% sensitivity and 97.2% specificity. DMS exhibits higher sensitivity than AET, whereas AET has greater specificity than DMS. The monitoring results of the both methods are highly consistent (P < 0.05). (2) Among the 105 patients with AET ranging from 4% to 6%, they were divided into DMS (+) and DMS (-) groups. Significant differences were observed between the two groups in terms of the total number of reflux episodes, number of reflux episodes lasting≥5 min, %supine time esophageal pH < 4, and longest reflux episode (in minutes). These findings suggest that these parameters should be considered and analyzed in addition to AET. (3) It is worth noting that more than 50% GERD patients with AET ranging from 4% to 6% still cannot determine the presence or absence of pathological reflux. Conclusion Both the diagnostic standards of AET and DMS provide robust supporting evidence for esophageal acid exposure. AET exhibits lower sensitivity but higher specificity compared to DMS. To enhance the sensitivity of AET, considering the hypothesis of AET>4% demonstrates esophageal acid exposure might be beneficial.
- Gastroesophageal reflux disease,
- pH monitoring,
- DeMeester score,
- Acid exposure time

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References(19)

References

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Analysis and comparison of impedance-pH monitoring parameters in diagnosis of GERD based on the "Lyon Consensus"

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