21 November 2020>: Clinical Research
The Role of Salivary Pepsin in the Diagnosis of Gastroesophageal Reflux Disease (GERD) Evaluated Using High-Resolution Manometry and 24-Hour Multichannel Intraluminal Impedance-pH Monitoring
Zihao Guo 12ABCDEF , Yanhong Wu 2AB , Li Li 2C , Jing Chen 2C , Shutian Zhang 1AFG* , Chuan Zhang 2BDG*DOI: 10.12659/MSM.927381
Med Sci Monit 2020; 26:e927381
Table 1 The demographic characteristics, endoscopy, 24-h pH-MII monitoring and HRM results of 130 patients with refractory GERD symptoms.
Conclusive GERD (n=48) | Inconclusive GERD (n=58) | Against GERD (n=24) | P | Pa | Pb | Pc | |
---|---|---|---|---|---|---|---|
Male gender, n (%) | 25 (52.1) | 17 (29.3) | 8 (33.3) | 0.048 | 0.017 | NS | NS |
Age, Mean±SD | 58.8±13.4 | 57.5±12.2 | 53.1±12.5 | 0.203 | NS | NS | NS |
BMI, Mean±SD | 24.6±3.0 | 23.8±3.7 | 23.2±4.2 | 0.235 | NS | NS | NS |
GERD-Q | 9.0 (7.0–11.0) | 8.0 (6.0–11.0) | 8.0 (6.0–9.0) | 0.632 | NS | NS | NS |
0.000 | 0.032 | ||||||
Normal, n (%) | 5 (10.4) | 16 (27.6) | 24 (100) | ||||
LA-A&B, n (%) | 38 (79.2) | 42 (72.4) | 0 | ||||
LA-C&D&BE, n (%) | 5 (10.4) | 0 (0) | 0 | ||||
AET (%) | 8.9 (6.8–27.8) | 1.5 (0.5–4.3) | 1.0 (0.3–2.0) | 0.013 | |||
DeMeester score | 31.2 (23.8–87.9) | 5.8 (1.8–13.3) | 4.1 (1.5–6.9) | 0.019 | |||
Distal MNBI (Ω) | 1316.6±719.7 | 2246.9±596.5 | 2388.2±654.4 | 0.034 | |||
PSPWI (%) | 19.0 (13.9–30.6) | 30.5 (23.2–36.7) | 43.9 (33.1–46.8) | ||||
Total reflux event (n) | 44.5 (19–82.3) | 55.0 (32.5–84.5) | 22.5 (17.3–32.8) | 0.002 | NS | ||
At 17 cm above LES | 2.5 (1.0–13.8) | 9.0 (2.0–19.0) | 5.0 (1.5–8.0) | 0.017 | NS | NS | 0.015 |
At 15 cm above LES | 13.0 (2.0–24.8) | 16.5 (4.8–35.3) | 8.5 (5.0–14.0) | 0.114 | NS | NS | 0.041 |
At 9 cm above LES | 30.5 (6.3–57.0) | 46.0 (22.8–73.3) | 19.0 (12.5–27.8) | 0.011 | NS | NS | |
At 7 cm above LES | 38.0 (9.8–74.8) | 51.0 (30.0–79.3) | 22.0 (17.0–31.0) | 0.012 | NS | 0.031 | |
At 5 cm above LES | 44.5 (19–79.5) | 55.9 (30.8–84.5) | 22.5 (17.3–32.8) | 0.008 | NS | 0.012 | |
At 3 cm above LES | 44.5 (19–82.3) | 55.0 (32.5–84.5) | 22.5 (17.3–32.8) | 0.002 | NS | ||
LES pressure | 5.1 (1.4–9.8) | 8.5 (4.7–11.9) | 7.4 (4.1–11.5) | 0.028 | NS | NS | NS |
EGJ type | 0.031 | 0.013 | NS | NS | |||
Type 1, n(%) | 4 (8.3) | 12 (20.7) | 6 (25) | ||||
Type 2, n(%) | 29 (60.4) | 40 (69.0) | 15 (62.5) | ||||
Type 3, n(%) | 15 (31.3) | 6 (10.3) | 3 (12.5) | ||||
EGJ-CI (mmHg·cm) | 12.7 (8.5–22.8) | 16.5 (9.3–22.9) | 16.0 (11.2–24.7) | 0.648 | NS | NS | NS |
Normal motility, n (%) | 14 (39.2) | 26 (44.8) | 16 (66.7) | 0.522 | NS | NS | NS |
DCI | 400.5 (192.5–668.0) | 553.0 (306.8–849.0) | 462.5 (280.8–1043.3) | 0.057 | 0.017 | 0.041 | NS |
At waking | 6.4 (2.7–11.3) | 3.0 (2.2–7.4) | 2.2 (1.3–2.4) | 0.011 | 0.001 | 0.012 | NS |
After meal | 6.3 (3.2–12.7) | 3.3 (2.3–6.1) | 2.3 (2.2–3.0) | 0.024 | NS | 0.003 | NS |
The higher conc. | 8.2 (3.8–17.8) | 4.0 (2.3–6.1) | 2.4 (2.2–3.1) | 0.007 | 0.023 | 0.003 | NS |
Values are presented as median and interquartile range, except for age, BMI, EGJ-CI, MNBI, and PSPWI (mean and standard deviation); and male sex, Lyon classification, EGJ type, and endoscopy (n and%). BMI – body mass index; GERD – gastroesophageal reflux disease; GERD-Q – gastroesophageal reflux disease questionnaire; BE – Barrett esophagus; AET – acid exposure time; MNBI – mean nocturnal baseline impedance; PSPWI – post-reflux swallow-induced peristaltic wave index; EGJ – esophagogastric junction; EGJ-CI – EGJ contractile integral; DCI – distal contractile integral. Differences were significant when |