资源描述：
《反流characteristics of》由会员上传分享，免费在线阅读，更多相关内容在行业资料-天天文库。
1、TheAmericanJournalofGastroenterology(2008)103,1090–1096;CharacteristicsofSymptomaticRefluxEpisodesonAcidSuppressiveTherapyRadu Tutuian MD1,MarceloF Vela MD1,ElizabethG Hill PhD2,Inder Mainie MD1,Amit Agrawal MD1andDonaldO Castell MD11.1DivisionofGastroenterologyandHepatology,MedicalUnivers
2、ityofSouthCarolina,Charleston,SouthCarolina2.2DepartmentofBiostatistics,BioinformaticsandEpidemiology,MedicalUniversityofSouthCarolina,Charleston,SouthCarolinaCorrespondence:RaduTutuian,MD,DivisionofGastroenterologyandHepatology,UniversityHospitalofZurich,Ramistrasse100,AHOF109,CH-8091Zuri
3、ch,Switzerland.AbstractBACKGROUND:Persistentsymptomsonacidsuppressivetherapyareduetoeitheracidornonacidgastroesophagealreflux(GER)episodesorarenotrelatedtoreflux.AIM:TocomparephysicalandchemicalcharacteristicsofGERepisodesassociatedwithsymptomsinpatientsonacidsuppressivetherapy.METHODS:Pat
4、ientswithpersistentsymptomsonacidsuppressivetherapyunderwentcombinedimpedance-pHmonitoring.RefluxepisodeswereclassifiedasacidifnadirpHwas<4.0,andnonacidifitremainedat4.0,separatedintoliquid-onlyormixed(liquid-gas),andconsideredtoreachtheproximalesophagusifliquidwaspresent15cmabovethelowere
5、sophagealsphincter(LES).Refluxepisodeswereconsideredsymptomaticifpatientsrecordedasymptomwithin5minaftertherefluxepisode.Riskfactorsofsymptomaticrefluxepisodeswereidentifiedusingmultivariablegeneralizedestimatingequations(GEEs).RESULTS:Onehundredtwentypatients(85women,medianage54yr,range18
6、–85yr)recorded3,547refluxepisodes(84.3%nonacid,50.6%mixed),ofwhich468(13.2%)weresymptomatic.BasedonmultivariableGEEanalysiswithepisode-levelsymptomstatus(symptomaticvsnonsymptomatic)astheoutcomevariable,refluxepisodeaciditywasnotsignificantlyassociatedwithsymptoms(P=0.40).Mixedrefluxepisod
7、esweresignificantlyassociatedwithsymptomsrelativetoliquid-onlyepisodes(oddsratio[OR]1.49,95%confidenceinterval[CI]1.19–1.87,P=0.0005),aswererefluxepisodesreachingtheproximalesophaguscomparedwiththosereachingthedistalesophagusonly(OR1.28,95%CI1.06–1.55,P=0.012)
