Objectives:

To elucidate the accuracy and advantages of Multichannel intraluminal impedance-pH monitoring (MII-pH) in diagnosing gastroesophageal reflux-induced chronic cough (GERC).

Methods:

The patients with suspected GERC were recruited and underwent MII-pH, GERC was confirmed by subsequent anti-reflux treatment despite the findings of MII-pH. Its diagnostic accuracy in identifying GERC were evaluated by receiver operating characteristic (ROC) analysis and compared with that of 24-h esophageal pH monitoring.

Results:

Among 158 patients completing both MII-pH and anti-reflux therapy, GERC was diagnosed in 136 patients, including acid GERC in 96 patients (70.6%), non-acid GERC in 30 patients (22.0%), neither one of both GERC in 10 patients (7.4%). For the identification of GERC, MII-pH presented with the sensitivity of 92.6%, specificity of 63.6%, positive predictive value of 94.0%, negative predictive value of 58.3% and area under ROC curve of 0.863, which was totally superior to 24-h esophageal pH monitoring. As the essential criteria of MII-pH, esophageal acid exposure time and symptom associated probability had a limited diagnostic value when used alone, but improved greatly the diagnostic yield when used in combination, even with a suboptimal efficacy.

Conclusion:

MII-pH is a more sensitive test for identifying GERC, but with a suboptimal diagnostic efficacy.

中文翻译：

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多通道管腔内阻抗-pH监测对胃食管反流性慢性咳嗽的诊断准确性

目标：

阐明多通道腔内阻抗-pH监测（MII-pH）在诊断胃食管反流引起的慢性咳嗽（GERC）中的准确性和优势。

方法：

招募疑似 GERC 的患者并接受 MII-pH，尽管 MII-pH 有结果，但通过随后的抗反流治疗证实了 GERC。通过受试者工作特征 (ROC) 分析评估其识别 GERC 的诊断准确性，并与 24 小时食管 pH 监测进行比较。

结果：

在完成 MII-pH 和抗反流治疗的 158 名患者中，136 名患者被诊断出 GERC，其中酸性 GERC 96 名患者（70.6%），非酸性 GERC 30 名患者（22.0%），GERC 和10 名患者 (7.4%)。MII-pH对GERC的鉴别敏感性为92.6%，特异性为63.6%，阳性预测值为94.0%，阴性预测值为58.3%，ROC曲线下面积为0.863，完全优于24- h 食管pH监测。作为 MII-pH 的基本标准，食管酸暴露时间和症状相关概率单独使用时诊断价值有限，但联合使用时可大大提高诊断率，即使疗效欠佳。

结论：

MII-pH 是用于识别 GERC 的更敏感的测试，但具有次优的诊断功效。