The Results From Up-Front Esophageal Testing Predict Proton Pump Inhibitor Response in Patients With Chronic Cough

医学 质子抑制剂泵 内科学 胃肠病学
作者
Mentore Ribolsi,Michele Pier Luca Guarino,Paola Balestrieri,Annamaria Altomare,A.M. Di Tullio,Tommasangelo Petitti,Michele Cicala
出处
期刊:The American Journal of Gastroenterology [Lippincott Williams & Wilkins]
卷期号:116 (11): 2199-2206 被引量:17
标识
DOI:10.14309/ajg.0000000000001389
摘要

The clinical management of chronic cough patients is challenging, and their response to proton pump inhibitors (PPIs) is considered as unsatisfactory. Few data concerning the association between impedance-pH variables and PPI response in these patients are available. Mean nocturnal baseline impedance (MNBI) and postreflux swallow-induced peristaltic wave (PSPW) index increase the diagnostic yield of impedance-pH in gastroesophageal reflux disease.Demographic, clinical, and endoscopy findings; impedance-pH; and high-resolution manometry tracings from consecutive patients assessed for cough were evaluated. Univariable and multivariable regression models were generated to evaluate the association between impedance-pH and high-resolution manometry findings, endoscopic and clinical characteristics, and PPI response.A total of 178 patients were included. Eighty-four of 178 cough patients (47.2%) displayed grade C-D erosive esophagitis or were characterized by a pathological acid exposure time (AET) and/or positive symptom association probability/symptom index. When also considering MNBI and PSPW, 135 of 178 patients (75.8%) were characterized by the evidence of reflux disease (P < 0.001). Eighty patients (44.9%) had cough responding to PPIs, whereas 98 (55.1%) were nonresponders (P = 0.071). At the receiver operating characteristic analysis, both PSPW index and MNBI were associated to PPI responsiveness. MNBI and PSPW index showed higher sensitivity in predicting PPI response compared with AET and symptom association probability/symptom index. The area under the curves of MNBI and PSPW index were significantly higher than that of AET (P < 0.01 for both comparisons). When patients were stratified according to AET and excluding those with erosive esophagitis, pathological MNBI or PSPW index, hiatal hernia, and hypomotility features were associated to PPI response in all groups.Our results demonstrate the usefulness of an up-front esophageal testing in discriminating reflux-related cough patients and predicting PPI response.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
田南松发布了新的文献求助10
1秒前
搬砖美少女完成签到,获得积分10
1秒前
nn发布了新的文献求助10
2秒前
7ohnny完成签到,获得积分10
3秒前
apckkk完成签到 ,获得积分10
5秒前
深情安青应助550190946采纳,获得10
6秒前
7秒前
8秒前
jbq完成签到 ,获得积分20
8秒前
YM完成签到,获得积分10
10秒前
生动柔发布了新的文献求助10
10秒前
大旭完成签到 ,获得积分10
11秒前
Fn完成签到 ,获得积分10
13秒前
zero完成签到,获得积分10
15秒前
瘦瘦谷兰完成签到,获得积分10
15秒前
zcz完成签到 ,获得积分10
16秒前
白嘉乐完成签到,获得积分10
17秒前
考研小白完成签到,获得积分10
17秒前
高妍纯完成签到 ,获得积分10
19秒前
21秒前
风中的丝袜完成签到,获得积分10
21秒前
赵赵完成签到,获得积分10
24秒前
24秒前
shiizii应助科研通管家采纳,获得10
25秒前
xuzj应助科研通管家采纳,获得10
25秒前
Mars应助科研通管家采纳,获得30
25秒前
Hello应助科研通管家采纳,获得10
25秒前
叶梓轩完成签到 ,获得积分10
25秒前
上官若男应助科研通管家采纳,获得10
25秒前
25秒前
25秒前
机智的锦程完成签到 ,获得积分10
26秒前
时尚俊驰发布了新的文献求助10
28秒前
华仔完成签到,获得积分10
28秒前
甜甜友容完成签到,获得积分10
32秒前
程哲瀚完成签到,获得积分10
32秒前
32秒前
副本完成签到 ,获得积分10
32秒前
淡然画笔完成签到,获得积分10
33秒前
生动柔完成签到,获得积分20
33秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038201
求助须知:如何正确求助?哪些是违规求助? 3575940
关于积分的说明 11373987
捐赠科研通 3305747
什么是DOI,文献DOI怎么找? 1819274
邀请新用户注册赠送积分活动 892662
科研通“疑难数据库(出版商)”最低求助积分说明 815022