Àç¹ß¼º È£Èí±â Áõ»óÀ» µ¿¹ÝÇÑ º´Àû À§½Äµµ ¿ª·ù Áúȯ¿¡¼ ÀÌÁß Ã¤³Î ½Äµµ³» pH °Ë»çÀÇ ÀÇÀÇ
Clinical Significance of Dual-probe Esophageal pH Monitoring in Pathological Gastroesophageal Reflux Disease with Recurrent Respiratory Symptoms
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¼Ò¼Ó »ó¼¼Á¤º¸
̅˱̢ ( Choi Yun-Chang )
Á¶¼±´ëÇб³ ÀÇ°ú´ëÇÐ ¼Ò¾Æ°úÇб³½Ç
¹®°æ·¡ ( Moon Kyung-Rye )
Á¶¼±´ëÇб³ ÀÇ°ú´ëÇÐ ¼Ò¾Æ°úÇб³½Ç
KMID : 0816120030060010017
Abstract
¸ñ Àû: 24½Ã°£ ÀÌ Áß Ã¤³Î ½Äµµ pH °Ë»ç¸¦ ÇÏ¿© À§½Äµµ ¿ª·ù¿Í È£Èí±â Áõ»ó°úÀÇ »óÈ£ °ü°è¸¦ ¾Ë¾Æº¸°í È£Èí±â Áõ»óÀÌ ÀÖ´Â ¿ª·ù ȯÀÚ¿¡¼ ¿øÀ§ºÎ¿Í ±ÙÀ§ºÎ ½Äµµ pH ÃøÁ¤Ä¡¸¦ ºñ±³ÇÏ°íÀÚ ¿¬±¸ÇÏ¿´´Ù.
¹æ ¹ý: 1998³â 8¿ùºÎÅÍ 2002³â 8¿ù±îÁö Á¶¼±´ëÇб³º´¿ø ¼Ò¾Æ°ú¿¡ À§½Äµµ ¿ª·ùÀÇ Áõ»óÀÌ Àְųª 3ÁÖÀÏ ÀÌ»óÀÇ ¸¸¼º ±âħ µî ÀæÀº È£Èí±â Áõ»óÀÌ ÀÖ¾î ½Äµµ pH °Ë»ç¸¦ ½Ç½ÃÇÑ 34¸í Áß ¿øÀ§ºÎ ½Äµµ¿¡¼ º´ÀûÀÎ ¿ª·ù¸¦ º¸ÀÎ 17¸íÀ» ´ë»óÀ¸·Î ÇÏ¿´´Ù. º´Àû ¿ª·ùÀÇ ±âÁØÀº 95¹éºÐÀ§¼ö ÀÌ»óÀÇ ¿ª·ùÁöÇ¥(reflux index)¸¦ º´Àû ¿ª·ù·Î Á¤ÀÇÇÏ¿´´Ù.
°á °ú: 1) ´ë»ó 34¸í¿¡¼ È£Èí±â Áõ»óÀÌ ÀÖ´Â 16¸í Áß 12¸í(75%), È£Èí±â Áõ»óÀÌ ¾ø´Â 18¸í Áß 5¸í(28%)¿¡¼ ¿øÀ§ºÎ ½Äµµ¿¡¼ º´Àû ¿ª·ù¸¦ º¸¿´´Ù. 2) I±º¿¡¼ ±ÙÀ§ºÎ¿Í ¿øÀ§ºÎÀÇ ¿ª·ù Áö¼ö, ÃÑ ¿ª·ùȽ¼ö, 5ºÐ ÀÌ»ó Áö¼ÓµÈ ¿ª·ùÀÇ È½¼ö, ÃÖÀå ¿ª·ù ½Ã°£ µî ¸ðµç Ç׸ñµéÀÌ À¯ÀÇÇÑ Â÷À̸¦ º¸¿´´Ù(P£¼0.05). 3) II±º¿¡¼ ±ÙÀ§ºÎ¿Í ¿øÀ§ºÎÀÇ ÃÖÀå ¿ª·ù ½Ã°£À» Á¦¿ÜÇÑ ¸ðµç Ç׸ñµéÀÌ À¯ÀÇÇÑ Â÷ÀÌ°¡ ¾ø¾ú´Ù(P£¾0.1). 4) ±ÙÀ§ºÎ ½Äµµ¿¡¼ I±º°ú II±ºÀÇ ¸ðµç Ç׸ñµéÀÌ À¯ÀÇÇÑ Â÷ÀÌ°¡ ¾ø¾ú´Ù(P£¾0.5).
°á ·Ð: ¿øÀ§ºÎ À§½Äµµ ¿ª·ù¸¦ º¸À̴ ȯÀÚ¿¡¼ È£Èí±â Áõ»óÀÇ À¯¹«¿¡ µû¶ó ±ÙÀ§ºÎ ½Äµµ pH °Ë»ç °á°úÀÇ ¸ðµç Ç׸ñ¿¡¼ Â÷À̸¦ º¸ÀÌÁö ¾Ê¾Æ Àç¹ß¼º È£Èí±â Áõ»óÀ» º¸À̴ ȯÀÚ¿¡¼ ÀÌÁßä³Î ½Äµµ pH °Ë»çÀÇ À¯¿ë¼º¿¡ ´ëÇØ Àç°í°¡ ÇÊ¿äÇÒ °ÍÀ¸·Î ÆǴܵȴÙ.
PURPOSE: The aim of this study was to determine clinical significance of dual-probe esophageal pH monitoring and to compare four pH monitoring parameters between proximal and distal esophagus in pathological gastroesophageal reflux disease with recurrent respiratory symptoms.
METHODS: Among the thirty-four patients who were performed 24 hr pH monitoring, seventeen patients with pathological distal reflux were classified into two groups: Group I (n£º12) had recurrent respiratory symptoms and Group II (n£º5) hadn¡¯t recurrent respiratory symptoms. The ambulatory dual-probe esophageal pH monitoring was performed for 18~24 hr. A pathologic GER was defined when reflux index (percent of the investigation time a pH£¼4) exceeded the 95th percentile of normal value.
RESULTS: Among the sixteen patients with recurrent respiratory symptoms, twelve patients (75%) have pathological distal reflux. Whereas among the eighteen patients without recurrent respiratory symptom, five patients (28%) have pathological distal reflux. In the Group I, the significant differences between proximal and distal esophageal pH recordings persisted for all parameters, but didn¡¯t persist in group II except for longest episode. Comparing esophageal pH four parameters between group I and group II at the proximal esophageal site, all parameters didn¡¯t show statistically significant differences.
CONCLUSION: Regardless of respiratory symptoms, patients with pathological distal reflux didn¡¯t show statistically significant differences in the all parameters at the proximal esophageal site. Therefore we may reconsider usefulness of dual probe pH meter in patients with recurrent respiratory symptoms.
Å°¿öµå
GERD;Recurrent respiratory symptoms;Dual-probe pH monitoring
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