论文部分内容阅读
[目的]评价典型反流症状在胃食管反流疾病(GERD)患者中的的诊断价值。[方法]选取2011年1月~2013年12月于本院消化内科就诊,有反流症状疑诊为GERD的122例患者为研究对象,以胃食管反流疾病问卷(GerdQ)评价患者的症状,以胃镜检查发现反流性食管炎(RE)和(或)质子泵抑制剂(PPI)试验阳性作为GERD的诊断标准,并进行RE的洛杉矶(LA)分级,据此将122例患者分为GERD组和非GERD组。比较2组的临床资料及GerdQ评分,通过受试工作者曲线(ROC)计算GerdQ的临界值、灵敏度、特异度以及Youden指数。[结果]122例患者中诊断为GERD者88例,占72.1%。GERD组和非GERD组患者在性别、年龄、阳性症状(烧心、反流)的发生率及其评分、阳性影响(睡眠障碍、服用药物)的发生率及其评分等方面无明显差异(P>0.05),GERD组的阴性症状(上腹痛、恶心)的发生率明显低于非GERD组(P<0.05),并且其评分均明显高于非GERD组(P<0.05)。各个LA级别的GerdQ总分比较差异无统计学意义(P>0.05)。ROC表明将9分作为其临界值时,灵敏度为81.2%,特异度为57.9%,Youden指数达到0.391,ROC曲线面积为0.65,诊断意义最大。[结论]典型反流症状可以在一定程度上帮助GERD的诊断,采用GerdQ自评问卷来评价反流症状,并以9分为临界值,有较高的诊断价值,可以作为初诊GERD简易有效的方法。
[Objective] To evaluate the diagnostic value of typical reflux symptoms in patients with gastroesophageal reflux disease (GERD). [Methods] From January 2011 to December 2013 in our hospital digestive medicine treatment, reflux symptoms were suspected of GERD 122 patients were studied, the gastroesophageal reflux disease questionnaire (GerdQ) to evaluate the patient’s symptoms , Gastroscopy was found to be positive for reflux esophagitis (RE) and / or proton pump inhibitor (PPI) test as the diagnostic criteria for GERD, and the LA of LA was graded to classify 122 patients into GERD group and non-GERD group. The clinical data and GerdQ score of two groups were compared. The critical value, sensitivity, specificity and Youden index of GerdQ were calculated by ROC. [Results] Of the 122 patients, 88 were diagnosed as GERD, accounting for 72.1%. There were no significant differences in the incidence and score of gender, age, positive symptoms (heartburn, reflux) and their scores, positive effects (sleep disorders, taking drugs) between GERD group and non-GERD group (P> 0.05). The incidence of negative symptoms (upper abdominal pain, nausea) in GERD group was significantly lower than that in non-GERD group (P <0.05), and the scores were significantly higher in GERD group than in non-GERD group (P <0.05). There was no significant difference in the GerdQ score between different LA levels (P> 0.05). ROC showed 9 points as its critical value, the sensitivity was 81.2%, specificity was 57.9%, Youden index reached 0.391, ROC curve area of 0.65, the diagnosis of the greatest. [Conclusion] The typical reflux symptoms can help diagnose GERD to a certain degree. The GerdQ self-assessment questionnaire is used to evaluate the symptoms of reflux. With 9 points as the critical value, it has high diagnostic value and can be used as a simple and effective initial GERD diagnosis method.