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Exertional esophageal pH-metry and manometry in recurrent chest pain

World Journal of Gastroenterology 2010年第34期16卷 4305-4312页

作者： Jacek Budzyński Department of Gastroenterology Vascular Diseases and Internal Medicine Nicolaus Copernicus University in Toruń Ludwik Rydygier Collegium Medicum in Bydgoszcz Poland Ujejskiego 75 Street 85-168 Bydgoszcz Poland Division of Vascular Diseases and Internal Medicine Dr Jan Biziel University Hospital No. 2 in Bydgoszcz Ujejskiego 75 Street 85-168 Bydgoszcz Poland

AIM: To investigate the diagnostic efficacy of 24-h and exertional esophageal pH-metry and manometry in patients with recurrent chest pain. METHODS: The study included 111 patients (54% male) with recurrent angina-like chest pain, non-respon- sive to therapy with proton pump inhibitors. Sixty-five (59%) had non-obstructive lesions in coronary artery angiography, and in 46 (41%) significant coronary artery narrowing was found. In all patients, 24-h esophageal pH-metry and manometry, and treadmill stress tests with simultaneous esophageal pH-metry and manometry monitoring were performed. During a 24-h examination the percentage of spontaneous chest pain (sCP) episodes associated with acid reflux or dysmotility (symptom index, SI) was calculated. Patients with SI > 50% for acid gastroesophageal reflux (GER) were classified as having GER-related sCP. The remaining symptomatic individuals were determined as having non-GER-related sCP. During the stress test, the occurrence of chest pain, episodes of esophageal acidification (pH test occurred in 13/111 (12%) subjects. In order to compare the clinical usefulness of 24-h esophageal function monitoring and its examination limited only to the treadmill stress test, the standard parameters of diagnostic test evaluation were determined. The occurrence of GER- related or non-GER-related sCP was assumed as a "gold standard". Afterwards, accuracy, sensitivity and specificity were calculated. These parameters expressed a prediction of GER-related or non-GER-related sCP occurrence by the presence of chest pain, esophageal acidification and EPES

关键词： Chest pain Diagnosis Esophageal manometry Esophageal pH-metry treadmill test

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