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目的反流性食管炎24 h pH监测症状指数的临床应用价值。方法内镜下确诊为反流性食管炎100例,在3 d内进行24 h食管内pH监测,采用Ward建立的数学表达式“症状指数”(symptom index,SI)分别分析烧心、胸痛的症状指数。结果经24 h pH监测所测得烧心SI,异常组SI百分率增高呈阶梯样上升,正常组随SI百分率增高呈阶梯样下降。异常组与正常组相比较,低SI≤25.0%无差异(P>0.05),而高SI≥50.0%,SI≥75.0%差异有显著性(P<0.01)。烧心轻、中、重程度也与SI百分率增高呈正相关性。烧心与酸反流的定量参数有相当密切的联系。高SI≥50.0%与SI≥75.0%无差异(P>0.05),将50%定为症状指数为妥。胸痛SI与酸反流关系不密切。结论 SI≥50%与24 h食管内pH监测结果有互补性,是制定治疗方案的依据。
Objective To evaluate the clinical value of 24 h pH monitoring symptom index in patients with reflux esophagitis. Methods 100 cases of reflux esophagitis were diagnosed by endoscopy. The esophageal pH was monitored within 24 hours after 3 days. The heart rate, chest pain and heart rate were analyzed by Ward’s mathematical expression “symptom index” (SI) Symptoms Index. Results The heart SI was measured after 24 h pH monitoring. The percentage of SI in the abnormal group was increased in a stepwise manner, while that in the normal group was decreased in a stepwise manner as the percentage of SI was increased. Compared with the normal group, there was no significant difference (P> 0.05) between the low SI≤25.0% and the high SI≥50.0%, SI≥75.0% (P <0.01). Heartburn light, moderate and severe degree of SI percentage increase was also positively correlated. Heartburn and acid reflux quantitative parameters are quite close contact. High SI ≥ 50.0% and SI ≥ 75.0% no difference (P> 0.05), 50% as the symptom index as appropriate. Chest pain SI and acid reflux is not closely related. Conclusion SI ≥ 50% and 24 h esophageal pH monitoring results are complementary, is the basis for the development of treatment options.