Ambulatory 24-Hour Esophageal Manometry and Ph-Metry in Patients with Noncardiac Chest Pain, but No Reflux Symptoms

二十四小時攜帶式食道壓力及酸鹼值監測術在無胃食道逆流症狀的非心因性胸痛診斷價值

余興焜(Hsing-Kuen Yu) ； 曾志堅(Chih-Chen Tseng) ； 張繼森(Chi-Sen Chang) ； 陳儉鏗(Gran-Hum Chen)

《The Kaohsiung Journal of Medical Sciences》 13卷5期 (1997/05) Pp. 293-300

https://doi.org/10.6452/KJMS.199705.0293

摘要

我們研究的目的是決定二十四小時攜帶式食道壓力及酸鹼值監測術對無胃食逆流症狀的非心因性胸痛的診斷價值。三十四例無胃食道逆流症狀的非心因性胸痛病人做二十四小時攜帶式食道壓力及酸鹼值監測檢查，壓力傳導器分別置於下食道括約肌上緣3，8，及13公分，酸鹼電極皆別置於下下食道括約肌上緣5緣及20公分；當病人胸時，壓一下控制鍵做配號。在二十四小時的記錄中，只有17位病人（50%）有至少一次以上胸痛（共81次，每人1至19次不等），其中21次胸痛（共81次，每人1至19次不等），其中21次胸痛（26%）與食道運動不正常有關，4次（5%）與胃食道逆流有關，10次（12%）與兩者同時有關；大部份胸痛的發生（46/81，57%）與食道運動及胃食道逆流無關。在7位患者胃食逆流有關的胸痛病賽當中有5位（71%）和11位患者與食道運動不正常有關的胸痛病人當有8位（73%）有大於95%的症狀相關可能性，也就是其症狀與食道不正常有意義的相關係。所以，二十四小時攜帶式食道壓力及酸鹼值監測術對於非心因性胸痛的評估是很有用的工具，但對無胃食道逆流症狀的非心因性胸痛，僅能發現少數與骨食逆流有關的胸痛。

並列摘要

The aim of this study is to deterimine the diagnostic value of 24-hour ambulatory esophageal manometry and pH-metry for patients with noncardiac chest pain (NCCP), but no reflux symptoms. Twenty-four hour ambulatory esophageal manometry and pH-metry was performed on 34 patients with NCCP, but no reflux symptoms. The pressure transducers were located 3, 8, and 13 cm above the lower esophageal sphincter (LES) and the pH probes were located 5 and 20 above the LES. An even marker was triggered by the patient for chest pain. Only 17 patients (50%) had at least one pain episode (total 81episodes, range 1-19 episodes per person) during a 24-hour recording. Twenty-one chest pain episodes (26%) occuared during abnormal motility, whereas 4 episodes (5%) were associated with pH ＜ 1, and 10 episodes (12%) had both abnormalities. The majority of chest pain episodes, 46 out of 81 events (57%), did not have any association with motility or pH abnormalities. Five of 7 patients (71%) with reflux-related chest pain and 8 of 11 patients (73%) with dysmotility- related chest pain had symptom association probability ＞ 95%, indicating a significant association between chest pain and esophageal dysfunction. Our conclusion is that ambulatory esophageal manometry and pH-metry is a useful tool in the evaluation of NCCP, but only a few additional patients with reflux-related chest pain could be found in patients without reflux symptoms.

並列關鍵字

esophageal motility disorders ； esophageal reflux disease ； noncardiac chest pain