超声多参数联合胃蛋白酶检测在婴幼儿胃食管反流相关性疾病诊断中的应用

Application of ultrasound multi-parameter examination combined with pepsin detection in the diagnosis of GER-related diseases of infants and young children

目的:探讨超声多参数联合胃蛋白酶检测在婴幼儿胃食管反流(GER)相关性疾病诊断中的应用。方法:选取医院收治的160例GER相关性疾病患儿并纳入GER组,另选取同期160名健康体检儿童纳入健康对照组。收集两组临床资料,分别进行胃蛋白酶、食管下括约肌腹段长度和胃贲门角检测,并进行统计学分析。结果:GER组患儿胃蛋白酶(30.15±4.93)ng/ml、胃贲门角(108.25±8.03)°,明显大于健康组,食管下括约肌腹段长度(2.39±0.47)cm明显小于健康对照组,差异有统计学意义(t=4.276,t=6.351,t=4.738;P<0.05)。Logistic回归分析结果显示,胃蛋白酶(OR=2.538,P<0.05)、食管下括约肌腹段长度(OR=2.661,P<0.05)及胃贲门角(OR=3.094,P<0.05)是观察患儿的独立危险因素。胃蛋白酶诊断GER的灵敏度为0.762,特异度为0.812;食管下括约肌腹段长度诊断GER的灵敏度为0.781,特异度为0.768;胃贲门角诊断GER的灵敏度为0.775,特异度为0.762;三者联合诊断GER的灵敏度为0.862,特异度为0.813,准确率为0.838。结论:胃蛋白酶、食管下括约肌腹段长度及胃贲门角是GER的危险因素,且三者联合诊断GER的价值较高,具有一定的临床意义。

Objective:To explore the application that ultrasound multi-parameter combined with pepsin detection in the diagnosis of gastroesophageal reflux(GER)-related diseases in infants and young children.Methods:160 children with GER-related diseases who admitted to hospital were selected and were divided into GER group,and 160 children who were healthy as the results of physical examination during the same period were divided into health group.The clinical data of two groups were collected,and the detections of pepsin,the length of abdominal segment of sub-esophageal constrictor and the angle of gastric cardia were respectively implemented,and then the data were analyzed by statistic method.Results:The pepsin and the angle of gastric cardia of GER group were(30.15±4.93)ng/ml and(108.25±8.03)°,which were significantly larger than those of health group,and the length[(2.39±0.47)cm]of the abdominal segment of sub-esophageal constrictor of GER group was significantly less than that of health group(t=4.276,t=6.351,t=4.738,P<0.05).The results of Logistic regression analysis showed that pepsin(OR=2.538,P<0.05),the length of abdominal segment of sub-esophageal constrictor(OR=2.661,P<0.05)and the angle of gastric cardia(OR=3.094,P<0.05)were independent risk factors of child patients.The sensitivity and specificity of pepsin was 0.762 and 0.812 in diagnosing GER,respectively.The sensitivity and specificity of the length of abdominal segment of sub-esophageal constrictor were 0.781 and 0.768 in diagnosing GER,respectively.And the sensitivity and specificity of the angle of gastric cardia were 0.775 and 0.762 in diagnosing GER,respectively.And the sensitivity,specificity and accuracy of the combination of the three methods were 0.862,0.813 and 0.838 in diagnosing GER,respectively.Conclusion:Pepsin,the length of abdominal segment of sub-esophageal constrictor and the angle of gastric cardia are risk factors of GER,and the value of the combined diagnosis of the three methods is higher for GER and it has a certain of clinical significance.