Post-reflux swallow-induced peristaltic wave index and mean nocturnal baseline impedance predict proton pump inhibitor response in patients with reflux hypersensitivity.

IF 3.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastroenterology and Hepatology Pub Date : 2024-08-08 DOI:10.1111/jgh.16718

Jie Liu, Mengqing Yin, Chaolan Lv, Wei Wang, Yizhou Huang, Jiashuang Tian, Bo Wang, Gengqing Song, Yue Yu

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引用次数: 0

Abstract

Background and aim: Post-reflux swallow-induced peristaltic wave (PSPW) index and mean nocturnal baseline impedance (MNBI) have been shown to influence proton pump inhibitor (PPI) response in GERD patients. However, currently, little data concerning these variables in patients with reflux hypersensitivity (RH) are available. In this study, we aimed to evaluate, in RH patients, the prevalence of PPI responders and nonresponders and investigate the predictive value of impedance-pH variables, including PSPW and MNBI, on responses to PPI.

Methods: A total of 108 RH patients who met ROME IV criteria were prospectively recruited from June 2018 to December 2022. The prevalence of PPI responders/nonresponders was calculated, and impedance-pH variables were compared between the response and nonresponse groups. Multiple logistic regression was used to investigate predictors for PPI response.

Results: Among 108 patients with RH, 60 patients (55.56%) were the PPI responders, and 48 (44.44%) were the nonresponders. Compared with the nonresponders, the PPI responders had a lower PSPW index (47.05 ± 4.43 vs 51.33 ± 3.50, P = 0.004) and a decreased value of MNBI (1866.68 ± 390.62 vs 2181.14 ± 338.42, P = 0.017). Multivariate logistic regression revealed that only the pathologic PSPW index (OR: 2.064) and MNBI (OR: 1.800) significantly influenced PPI response.

Conclusions: Nearly half of RH patients were PPI nonresponders. Impedance-pH monitoring was more valuable than pH-only monitoring in associating PPI response to reflux in RH patients owing to the appraisal of the PSPW index and MNBI.

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反流吞咽后引起的蠕动波指数和平均夜间基线阻抗可预测反流过敏症患者对质子泵抑制剂的反应。

背景和目的：反流后吞咽诱发蠕动波（PSPW）指数和平均夜间基线阻抗（MNBI）已被证明会影响胃食管反流病患者对质子泵抑制剂（PPI）的反应。然而，目前有关反流过敏症（RH）患者这些变量的数据还很少。在本研究中，我们旨在评估 RH 患者中 PPI 反应者和无反应者的比例，并研究阻抗-pH 变量（包括 PSPW 和 MNBI）对 PPI 反应的预测价值：从2018年6月至2022年12月，共前瞻性招募了108名符合ROME IV标准的RH患者。计算了 PPI 反应者/无反应者的患病率，并比较了反应组和无反应组之间的阻抗-pH 变量。多重逻辑回归用于研究 PPI 反应的预测因素：108 例 RH 患者中，60 例（55.56%）对 PPI 有反应，48 例（44.44%）无反应。与无反应者相比，PPI 反应者的 PSPW 指数较低（47.05 ± 4.43 vs 51.33 ± 3.50，P = 0.004），MNBI 值也较低（1866.68 ± 390.62 vs 2181.14 ± 338.42，P = 0.017）。多变量逻辑回归显示，只有病理 PSPW 指数（OR：2.064）和 MNBI（OR：1.800）对 PPI 反应有显著影响：结论：近一半的 RH 患者对 PPI 无应答。由于 PSPW 指数和 MNBI 的评估作用，阻抗-pH 监测比单纯 pH 监测更有价值，可将 RH 患者的 PPI 反应与反流联系起来。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Gastroenterology and Hepatology 医学-胃肠肝病学

CiteScore

7.90

自引率

2.40%

发文量

326

审稿时长

2.3 months

期刊介绍： Journal of Gastroenterology and Hepatology is produced 12 times per year and publishes peer-reviewed original papers, reviews and editorials concerned with clinical practice and research in the fields of hepatology, gastroenterology and endoscopy. Papers cover the medical, radiological, pathological, biochemical, physiological and historical aspects of the subject areas. All submitted papers are reviewed by at least two referees expert in the field of the submitted paper.