Ding Zhao-lu, Wang Guo-li, Ji Wen-jing, Xu Xi-wei
Department of Gastroenterology, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China.
Zhonghua Yi Xue Za Zhi. 2010 Sep 14;90(34):2396-8.
To evaluate the value of reflux diagnostic questionnaire in the diagnosis of children with gastroesophageal reflux disease (GERD).
Forty-five children aged 7-16 years old referred for suspected GERD with vomiting/regurgitation, nausea, heartburn/retrosternal pain, abdominal pain, epigastric pain, acid regurgitation and pain while swallowing were assessed. Each symptom was rated from 0 to 3 according to its severity and frequency. The items of questionnaire were validated against the results from upper gastrointestinal endoscopy and esophageal 24 h pH monitoring. And the results were compared with symptom scores to determine the threshold value for GERD.
In 45 patients, the ratio of male to female was 1.37:1 and the mean age (11.1±2.6) years old. Composite score in 23 patients with GERD (20±10) was significantly higher than that in 22 patients without GERD (13±4) (P<0.05). There was no significant difference of composite scores among patients with grades 0, I, II and III according to upper gastrointestinal endoscopy (P>0.05). With 13.0 as threshold score for GERD, the sum of sensitivity and specificity was maximal. The area under the receiver operating characteristic curve (ROC) was 0.79 while true positive diagnostic rate 72.0% and true negative diagnostic rate 75.0% with a sensitivity of 78.3%, a specificity of 68.2% and an accuracy of 73.3%.
Reflux diagnostic questionnaire is a suitable method in initial diagnosis of GERD. It may serve as a screening test for GERD in 7-16-year-old children.
评估反流诊断问卷在儿童胃食管反流病（GERD）诊断中的价值。
对45例年龄在7至16岁、因疑似GERD伴有呕吐/反流、恶心、烧心/胸骨后疼痛、腹痛、上腹部疼痛、反酸及吞咽时疼痛而前来就诊的儿童进行评估。根据每种症状的严重程度和频率从0至3进行评分。将问卷项目与上消化道内镜检查及食管24小时pH监测结果进行验证。并将结果与症状评分进行比较以确定GERD的阈值。
45例患者中，男女比例为1.37:1，平均年龄（11.1±2.6）岁。23例GERD患者的综合评分（20±10）显著高于22例非GERD患者（13±4）（P<0.05）。根据上消化道内镜检查，0、I、II和III级患者的综合评分无显著差异（P>0.05）。以13.0作为GERD的阈值评分时，灵敏度和特异度之和最大。受试者操作特征曲线（ROC）下面积为0.79，真阳性诊断率为72.0%，真阴性诊断率为75.0%，灵敏度为78.3%，特异度为68.2%，准确度为73.3%。
反流诊断问卷是GERD初步诊断的合适方法。它可作为7至16岁儿童GERD的筛查试验。
