GerdQ量表在胃食管反流病诊断中的应用

Value of GerdQ for diagnosis of gastroesophageal reflux disease

目的：探讨胃食管反流病量表（GerdQ）应用于诊断胃食管反流病（GERD）的价值。方法对2013年6月至2014年10月在新疆维吾尔自治区人民医院就诊收住并存在反流相关症状的疑似胃食管反流病的1000例患者进行问卷调查，按照烧心、反流、上腹痛、恶心、睡眠障碍、是否服用 OTC 药物等6项症状的发作频率进行评分。采用上消化道内镜检查及食管24 h pH 监测作为GERD 诊断的标准，并与 GerdQ 分值进行比较，最后计算出诊断 GERD 的临界值，进而分析 GerdQ 量表在 GERD 中的诊断价值。结果GERD 组的 GerdQ 积分主要集中于7-12分，非 GERD 组主要集中于6分以下，差异有统计学意义（P ＜0．05）。以 GerdQ 分值8为临界值，Youden 指数最大（0．51）， ROC 曲线下的面积0．765，其敏感度为81．32％，特异性为70．21％，阳性预测值83．24％，阴性预测值61．53％。结论GerdQ 量表简单、易行，可作为临床上筛查诊断 GERD 的有效方法。

Objective To explore the validation of the gastroesophageal reflux disease questionnaires （GerdQ）for the diagnosis of gastroesophageal reflux disease （GERD）.Methods A total of 1 000 patients who existed of reflux symptoms were surveyed of in The People′s Hospital of the Xinjiang Uygur Autonomous Region from June 2013 to October 2014,which was used to investigate reflux -related symptoms including heartburn,reflux,epigastric pain,nausea,sleep disturbance,and additional medicine （over the counter medication）.The results of their upper gastrointestinal endoscopy and 24-hour esophageal pH-impedance monitoring were compared with GerdQ score to determine the diagnostic cut-off score for GERD and analyze the validation of the GerdQ for the diagnosis of GERD.Results GerdQ scores of GERD group focused primarily on 7-12 points,GerdQ scores of control group focused primarily on the following six points,the difference was statistically significant （P 〈0.05）.Taking 8 as GerdQ cut-off score for GERD, we got the maximal Youden index （0.51）,in which the area under ROC was 0.765,with a sensitivity of 81.32% and specificity of 70.21%,the true positive diagnostic rate 83.24%,while true negative diagnostic rate 61.53%.Conclusion GerdQ is simple,easy,effective method,it can be used as the preliminary clinical diagnosis of GERD.