Application research of mean nocturnal baseline impedance and post-reflux swallow-induced peristaltic wave index in the diagnosis and efficacy evaluation of patients with endoscopic negative heartburn
HE Jing-jing
LI Yue
HU Xiang-peng
SONG Sha-sha
LU Yan
ZHANG Li-jiu
Abstract：Objective To investigate the diagnostic value of the MNBI and PSPW index in patients with endoscopy-negative heartburn and its relationship with the efficacy of PPIs.Methods High-resolution esophageal manometry,questionnaires,and multichannel 24-hour impedance-pH monitoring were selected from patients with gastroscopy suggesting that the esophageal mucosa was not broken and with typical heartburn symptoms who presented to the department of gastroenterology of the Second Affiliated Hospital of Anhui Medical University from March 2022 to July 2023.61 patients were enrolled according to the examination results,of which 20 were NERD,9 were RH and 32 were FH.The reflux indexes of the three groups were compared,and the diagnostic value of distal MNBI and PSPW indexes for FH was investigated by ROC analysis.All patients were divided into the PPI effective group(32 patients)and the ineffective group(29 patients)according to the questionnaire,and the reflux indexes of the two groups were compared,and the factors affecting the efficacy of PPI were analysed by applying bicategorical logistic regression.Results Distal MNBI and PSPW index were higher in FH group than in RH and NERD groups(P＜0.05),the distal MNBI was higher in the RH group than in the NERD group(P＜0.05);Using distal MNBI and PSPW index to diagnose FH,the area under the ROC curve was 0.743 and 0.908;the cut-off value of distal MNBI was 1981.88 Ω,the sensitivity was 43.8％,and the specificity was 100％;the cut-off value of PSPW index was 15.25％,the sensitivity was 78.1％,and the specificity was 100％.Logistic regression shows that the OR for distal MNBI in the PPI ineffective group is 1.003(P=0.011).Conclusion Distal MNBI and PSPW index can be used for a differential diagnosis of FH and RH,and distal MNBI can be an independent risk factor for ineffective PPI in patients with endoscopy-negative heartburn.
Keywords：mean nocturnal baseline impedancepost-reflux swallow-induced peristaltic waveproton pump inhibitor24-hour impedance-pH monitoringheartburn
Publication Date：2024-10-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 836-841,847 )