胃食管反流病问卷在反流性食管炎诊断中的应用

The Application of Gastroesophageal Reflux Disease Questionnaire (Gerd Q) in the Diagnosis of Reflux Esophagitis

目的分析胃食管反流病问卷(GerdQ)在反流性食管炎诊断中的应用价值。方法共有720名患者参与此项研究,361例通过胃镜检查明确诊断为反流性食管炎(RE),359例为对照组,均完成胃食管反流病问卷(GerdQ)的填写,计量资料采用t检验,计数资料采用卡方检验,等级资料统计采用Spearman相关分析。ROC曲线用于确定RE诊断的最佳截断点,P<0.05被认为具有统计学差异。结果对照组绝大部分积分在0-6分之间,占87.74%,而RE组绝大部分积分在7分~14分之间,占72.58%,RE组GerdQ评分(8.12±2.99)分明显高于对照组(5.70±1.95)分,两组比较有显著性差异(P<0.05);361例RE患者内镜下食管粘膜损伤程度根据LA分级进行诊断,Spearman相关分析显示LA不同等级之间GerdQ积分无显著性差异(P>0.05);GerdQ 8分为诊断RE的最佳截断点,诊断灵敏性为91.35%,特异性为87.61%。结论胃食管反流病问卷对诊断反流性食管炎具有重要的价值,其诊断本病的最佳截断点为8分,但积分高低与本病内镜下食管粘膜损伤程度无明显相关性。

Objective To evaluate the value of gastroesophageal reflux disease questionnaire（Gerd Q）in the diagnosis of reflux esophagitis. Methods A total of 720 patients participated in this study,361 were diagnosed as reflux esophagitis（RE）by gastroscopy and 359 were healthy controls. All of them completed the Gerd Q. The t test was used to measure data. Chi-square test was used to count data. Spearman correlation analysis was used for ranking data statistics. The ROC curve was used to determine the optimal cut-off point for diagnosis of RE. p 0.05 was considered statistically significant. Results Most of the scores in the control group ranged from 0 to 6 points,accounting for 87.74%,while most scores in the RE group ranged from 7 to 14 points,accounting for 72.58%.Gerd Q score of RE group（8.12±2.99）was significantly higher than that of control group（5.70±1.95）,there was significant difference between two groups（p 0.05）; The degree of endoscopic esophageal mucosal damage in 361 patients with RE was diagnosed according to LA classification. Spearman correlation analysis showed that there was no significant difference in Gerd Q scores between different grades of L A（P〉0.05）; Gerd Q 8 points is the best cut-off point for diagnosis of RE with a diagnostic sensitivity of 91.35% and a specificity of 87.61%. Conclusions The gastroesophageal reflux disease questionnaire had important value in diagnosing reflux esophagitis. The best cut-off point for diagnosing the disease was 8 points,but there was no significant correlation between the level of the integral and the degree of esophageal mucosal damage under endoscopy.