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目的 :探讨食管运动功能检查及兰索拉唑治疗试验对非心源性胸痛患者病因诊断的价值.方法 :对 63例经临床及心血管方面检查明确为非心脏起因的发作性胸痛患者进行内镜、食管测压、2 4 h食管腔内 p H监测及 7天的兰索拉唑治疗试验.结果 :63例中符合胃食管反流病 ( GERD) 4 4例 ( 70%) ,非特异性食管运动障碍 6例 ( 10%) ,贲门失弛症 3例 ( 5%) ,未明原因 10例.兰索拉唑治疗试验对诊断 GERD的敏感性为 91%( 2 0 /2 2 ) ,而安慰药有效率仅 9%( 2 /2 2 ) ,差异有显著意义 ( P“,”Objective: To evaluate the value of esophageal motility measurement and lansoprazole therapeutic test for noncardiac chest pain Methods:Endoscopy, esophageal manometry and 24 hour esophageal pH metry were performed in 63 patients with noncardiac chest pain. All subjects underwent a diagnostic test by receiving lansoprazole 30 mg or placebo twice daily for 7 days A symptom reduction of over 75% was considered positive Results:70% of patients(44/63)were diagnosed as gastroesophageal reflux disease(GERD). Nonspecific esophageal motor dysfunction and achalasia were diagnosed in 10%(6/63)and 5%(3/63)of patients respectively. In the remaining 10 cases,the causes of chest pain were unknown The sensitivity of lansoprazole therapeutic test was 91%(20/22)in the patients with GERD confermed by 24 hour esophageal pH metry,compared to 9% in placebo( P <0 05) The specificity of lansoprazole therapeutic test was 84%(16/19)for diagnosis of GERD Conclusion:The esophageal manometry、24 hour esophageal pH monitoring are useful in the diagnosis of noncardiac chest pain,and lansoprazole therapeutic test appears to have high sensitivity and specificity for the diagnosis of GERD,and it is practical, simple and convenient for clinical application