青少年胃食管反流病评分与胃镜表现特点的对照研究

Comparative Study Between the Scores and Gastroscopic Findings of Gastroesophageal Reflux Disease in Adolescents

【目的】探讨青少年胃食管反流病（GERD）问卷评分（GERDQ）与胃镜表现特点的关系。【方法】选择2010年1月至2014年1月在本院就诊的GERD患者51例，同一时期同科非GERD患者50例为对照组，并比较GERDQ与胃镜检查对GERD的诊断价值。【结果】患者的GERDQ评分分布情况结果显示GERD组患者GERDQ评分主要以8～11分为主，其所占患者比例达62．7％，对照组患者GERDQ评分以7～9分为主，所占患者比例达50．0％。GERD组胃镜检查阳性结果42例（82．4％），阴性结果9例（17．6％），对照组阴性结果36例（72．0％），阳性结果14例（28．0％）。根据GERDQ评分的ROC结果，取临界值7．5时，其诊断的敏感度和特异度最佳，分别为敏感度84．3％，特异度56．0％，阳性预测值66．6％，阴性预测值77．4％。【结论】青少年GERD的GERDQ评分及胃镜检查均有良好的诊断效果，其中GERDQ的青少年GERD诊断临界值为7．5，相对的胃镜表现以LA分级A ，B级为主，即青少年GRED病情普遍较轻。

[Objective]To explore the questionnaire scores and gastroscopic findings of gastroesophageal reflux disease（GERD） in adolescents .[Methods]Totally 51 patients with GRED in our hospital from Jan . 2010 to Jan .2014 were chosen .Other 50 concurrent patients without GRED in the same department were chosen as the control group .The diagnostic critical value was calculated .The diagnostic value between questionnaire scores of GERD（GERDQ） and gastroscopy of GERD was compared .[Results]The distribution result of GERDQ scores of patients showed that GERDQ in GERD group was mainly 8～11 scores which the proportion of patients was 62 .7% ,while that in control group was mainly 7～9 scores which the proportion of patients was 50 .0% .There were 42 patients with positive results of gastroscopy （82 .4% ） and 9 patients with negative results（17 .6% ） in GERD group ,while there were 14 patients with positive results （28 .0% ） and 36 patients with negative results （72 .0% ） in control group .According to ROC result pf GERDQ score ,the diagnostic sensitivity and specificity were the best when the critical value was 7 .5 .The sensitivity ,specificity ,positive predictive value and negative predictive value were 84 .3% ,56 .0% ,66 .6% and 77 .4% ,respectively .[Conclusion]Both GERDQ score and gastroscopy for the diagnosis of GERD have good effect .If the critical value of GERDQ for the diagnosis of GERD was 7 .5 and the relative gastroscopic findings are mainly LA classification A and Band in adolescents ,the pathogenetic condition of GERD in adolescents is generally milder .