胃食管反流性咳嗽的诊断路径：从经验性识别到基于MII-pH的多维评估
Diagnostic pathways for gastroesophageal reflux cough: From empirical recognition to MII-pH-based multidimensional assessment.
文献信息
| PMID | 42745699 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Chang Liu |
| 作者单位 | Laboratory of Cough, Affiliated Kunshan Hospital of Jiangsu University, Kunshan Key Laboratory of Chronic Cough, Suzhou, China. |
| 期刊 | Therapeutic advances in respiratory disease |
| SCI 分区 | Q2 |
| IF | 3.5 |
| 研究类型 | 综述 Meta · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 胃食管反流性咳嗽（GERC）被认为是慢性咳嗽的主要病因之一。然而，传统诊断方式存在极高的误诊率。这种情况常使临床医生陷入依赖经验性治疗试验的困境。
方法： 结合2024年Lyon共识2.0，本综述旨在探讨24小时多通道腔内阻抗-pH（MII-pH）监测在GERC精准诊断中的重要价值。
主要发现： 本综述首先阐明了排除性广谱筛查和无创初步评估在早期临床分诊中的基础作用。随后，深入分析了MII-pH的双重物理-化学监测理论，系统解释了该检查方法的四项主要指标。此外，通过整合高分辨率测压（HRM）和口咽pH监测（Restech），本综述构建了个体化、阶梯式的临床诊断路径。最后，本综述列出了MII-pH的局限性，并提出了未来展望。
结论： MII-pH监测在GERC的诊断中起着关键作用。它可评估反流事件及反流-咳嗽关联。与其他诊断工具联合使用，可提高诊断准确性并为临床决策提供支持。尽管存在局限性，未来随着技术的发展，MII-pH在GERC诊断中将更具价值。
英文摘要
BackgroundGastroesophageal reflux cough (GERC) is recognized as one of the leading etiologies of chronic cough. However, traditional diagnostic modalities suffer from exceptionally high misdiagnosis rates. This situation frequently puts clinicians in a dilemma of relying on empirical therapeutic trials.MethodsIntegrated with the 2024 Lyon Consensus 2.0, this review aims to explore the crucial value of 24-hour multichannel intraluminal impedance-pH (MII-pH) monitoring in the precision diagnosis of GERC.Main findingsThis review first clarifies the fundamental role of exclusionary broad-spectrum screening and non-invasive initial assessments in early clinical triage. Then, it provides a deep analysis of the dual physical-chemical monitoring theories of MII-pH, systematically explains the four main index of this inspection method. Furthermore, by integrating High-Resolution Manometry (HRM) and oropharyngeal pH monitoring (Restech), this review to construct an individualized, stepwise clinical diagnostic pathway. In the end, this review lists the limitation of MII-pH,provokes the future outlook.ConclusionsMII-pH monitoring plays a critical role in the diagnosis of GERC. It provides assessment of reflux events and reflux-cough associations. Combined with other diagnostic tools, it improves the diagnostic accuracy and provides support for clinical decision making. Despite its limitations, in the future, with the development of technology, MII-pH shall be more valuable in the diagnosis of GERC.