Clinical Value Of 24-Hour Esophageal PH-Empedance Monitoring In The Diagnosis Of Gastroesophageal Reflux Cough

Objective: To investigate the reflux characteristics of patients with gastroesophageal reflux cough based on the 24-hour ambulatory esophageal impedance-p H monitoring(MII-p H) technique.Methods: Retrospectively analyzed 60 cases with Gastroesophageal reflux disease,all of them had received the detection of MII-p H in our hospital in February 2014 to February 2016 period. All patients after MII-p H and other tests were in line with the diagnosis of GERD. The 31 patients of them who were diagnosed with gastroesophageal reflux cough(GERC) by the respirtory department and/or the otolaryngology department were defined as GERC+ group. The GERC- goup was defined as the other 29 patients who without cough performance. The inspection results of MII-p H was compared and analyzed in two groups.Result: In the comparing of reflux content with different p H values,weakly acid reflux in GERC+ group was more than in GERC- group(P<0.05).Concerning the state of reflux,both mixed reflux and gas reflux in GERC+ group were higher than in GERCgroup(P<0.05).No matter in the channel Z1(LES 15 cm distance)or the channel Z2(LES 15 cm distance),the GERC+ group had more reflux occurs. The number of proximal reflux episodes(Z1+Z2) in GERC+ group was larger. After the adjustment of confounders,in the correlation analysis between the GERD patients with GERC and the weakly acid reflux,the channel Z1 reflux, the channel Z2 reflux,the proximal reflux,and the mixed reflux,the OR value(95%CI)(P) were1.014(1.001-1.028)(P=0.037),1.070(1.012-1.133)(P=0.017),1.115(1.022-1.216)(P=0.014),1.070(1.001-1.033)(P=0.036),respectively. The result disclosed that the risk factors of the weakly acid reflux, the mixed reflux and the proximal reflux were the independent risk factors of the GERD patients with GERC.Conclusions: 1. The 24-hour ambulatory esophageal impedance-p H monitoring(MII-p H) technique contributed to the diagnosis of gastroesophageal reflux cough(GERC),and improved the detection of gastroesophageal reflux cough(GERC). 2. The risk factors of the weakly acid reflux, the mixed reflux and the proximal reflux were the independent risk factors of the GERD patients with GERC.