Department of Gastroenterology, Peking University People's Hospital, Beijing 100044, China.
Chin Med J (Engl). 2013 Dec;126(23):4430-4.
Symptoms, endoscopy, and pH monitoring form the basis of diagnosis of gastroesophageal reflux disease (GERD). Their relationship was meaningful for primary care physicians, but still unclear. Our research aimed to compare questionnaire, endoscopy, and pH monitoring and to analyze their correlations.
Three hundred patients who underwent the Reflux Disease Questionnaire (RDQ), endoscopy, and esophageal 24-hour pH monitoring from March 2007 to December 2010 in Peking University People's Hospital were enrolled. We analyzed the characteristics of different investigations and their relationships.
Male (OR for mild reflux esophagitis (RE) = 2.433, severe RE = 8.386), body mass index (BMI) (OR for mild RE = 1.222, severe RE = 1.297), and hernia (OR for mild RE = 6.059, severe RE = 17.547), were found to be the risk factors for RE; age (OR = 1.074) was correlated with severe RE. The consistency of questionnaire, endoscopy, and pH monitoring was poor: RDQ did not agree well with pH monitoring (κ = 0.061), nor with endoscopy (κ = 0.044); pH monitoring did not agree well with endoscopy (κ = 0.316). However, the severity of mucosa injury in RE was associated with pathological acid exposure (PAE): reflux episodes of >5 minutes (P = 0.035), the percentage time pH <4 (P = 0.017), and the DeMeester score (P = 0.016) increased significantly in patients with severe RE. Chest pain had poor relationship with RE or PAE.
Male, age, BMI, and hernia were probably risk factors for esophagitis. RDQ, endoscopy, and pH monitoring have their own focus and reinforce each other in diagnosis. Of the GERD symptoms, chest pain had negative correlation with RE or PAE.
症状、内镜和 pH 监测是胃食管反流病（GERD）诊断的基础。它们之间的关系对初级保健医生具有重要意义，但仍不清楚。我们的研究旨在比较问卷、内镜和 pH 监测，并分析它们之间的相关性。
2007 年 3 月至 2010 年 12 月，北京大学人民医院对 300 例接受反流病问卷（RDQ）、内镜和食管 24 小时 pH 监测的患者进行了研究。我们分析了不同调查的特点及其相关性。
男性（轻度反流性食管炎（RE）的比值比（OR）=2.433，重度 RE = 8.386）、体重指数（BMI）（轻度 RE 的 OR = 1.222，重度 RE = 1.297）和疝（轻度 RE 的 OR = 6.059，重度 RE = 17.547）是 RE 的危险因素；年龄（OR = 1.074）与重度 RE 相关。问卷、内镜和 pH 监测的一致性较差：RDQ 与 pH 监测（κ=0.061）和内镜（κ=0.044）均不一致；pH 监测与内镜（κ=0.316）不一致。然而，RE 黏膜损伤的严重程度与病理性酸暴露（PAE）有关：反流事件大于 5 分钟（P = 0.035）、pH 值小于 4 的时间百分比（P = 0.017）和 DeMeester 评分（P = 0.016）在重度 RE 患者中显著增加。胸痛与 RE 或 PAE 关系不佳。
男性、年龄、BMI 和疝可能是食管炎的危险因素。RDQ、内镜和 pH 监测在诊断中有各自的侧重点，相互补充。在 GERD 症状中，胸痛与 RE 或 PAE 呈负相关。
