Dx-pH检测系统在小儿反复喘息性疾病中的应用价值

Application of Dx-pH detection system in children with recurrent wheezing

目的探讨Dx-pH检测系统在小儿反复喘息性疾病中的应用价值,了解咽喉反流(LPR)与小儿喘息性疾病的关系。方法选择住院和门诊的30例反复喘息性疾病患儿为观察组,另择接受体检的健康儿童30例为对照组,均行美国Dx-pH系统检测,并进行反流体征评分(r RFS)量表和反流症状指数(RSI)量表评分。记录两组站立及卧位时Ryan指数、LPR发生率,分析量表评分与Ryan指数的关系。结果观察组站立时Ryan指数、卧位时Ryan指数均高于对照组(均P<0.05);观察组LPR发生率高于对照组(P<0.05);观察组气道酸性反流发生率为70.00%(14/20),高于气道碱性反流发生率30.00%(6/20)(P<0.05)。Ryan指数评分与RSI或和RFS量表评分结果不一致,如以Ryan指数为检测LPR金标准,则量表评分准确度为60.00%(18/30),特异度为20.00%(2/10),灵敏度为80.00%(16/20)。结论 LPR的发生与小儿喘息性疾病密切相关,以气道酸性反流较为常见,Dx-pH检测系统能准确检测LPR反流事件,减少误诊。

Objective To assess the application of Dx-pH detection system in children with recurrent wheezing caused by laryngo-pharyngeal reflux （LPR）.Methods Thirty children with recurrent wheezing （study group） and 30 healthy children （control group） were enrolled in the study.All subjects were examined by Dx-PH detection system,and graded by reflux finding score （RFS） and reflux symptoms index （RSI）.The Ryan index and the incidence of LPR in standing and lying position of two groups were compared.Results The Ryan index in standing and lying position of study group were higher than those of control group （P〈0.05）.The incidence of LPR in study group was significantly higher than that in control group （P〈0.05）.The incidence of airway acid reflux in study group was 70.0%（14/20）,and the incidence of airway alkaline reflux was 30.0%（6/20）（P〈0.05）.With Ryan index score as gold standard,the sensitivity,specificity and accurate rate of RIS or RFS scores were 80.0%（16/20）,20.0% （2/10） and 60.0%（18/30）,respectively.Conclusion The occurrence of LPR is closely correlated with wheezing in children,and airway acid reflux is mostly common.Dx-PH detection system can accurately detect the existence of LPR so as to decrease the misdiagnosis rate.