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儿童胃食管反流病不同pH值测定评分之间的相关性

Correlation between the different pH-metry scores in gastroesophageal reflux disease in children.

作者信息

Lupu Vasile Valeriu, Ignat Ancuţa, Paduraru Gabriela, Ciubara Anamaria, Moscalu Mihaela, Marginean Cristina Oana, Burlea Marin

机构信息

aPediatrics Department, University of Medicine and Pharmacy "Gr. T. Popa bVth Pediatrics Clinic, "St. Mary" Children Emergency Hospital cPsychiatry Department dMedical Informatics and Biostatistics Department, University of Medicine and Pharmacy, "Gr. T. Popa", Iasi, Romania ePediatrics Department, University of Medicine and Pharmacy, Targu Mures, Romania.

出版信息

Medicine (Baltimore). 2016 Jun;95(26):e3804. doi: 10.1097/MD.0000000000003804.

Abstract

The 24-hour esophageal pH-metry is the most widely used method to diagnose the gastroesophageal reflux disease (GERD). The study compares the different scores obtained during the 24-hour esophageal pH-metry. A retrospective study over 5 years including 234 children (1 month and 18 years old) admitted in a pediatric gastroenterology regional center in Northeast Romania, with suspicion of GERD. They underwent 24- hour esophageal pH-metry, and the scores obtained (Boix-Ochoa, DeMeester, Johnson-DeMeester) were compared. Out of the 234 children, 172 (73.50%) had positive Boix-Ochoa score and 62 (26.50%) had normal Boix-Ochoa score (<11.99). Based on the DeMeester score, 149 children (63.68%) were positive and 85 (36.32%) were negative. The correlation of the Demeester score with the Boix-Ochoa score was very high (r = 0.978, P <  < 0.01, 95% confidence interval). Considering the Johnson-DeMeester score, 120 cases (51.28%) had GERD and 114 (48.72%) did not. The correlation of the Johnson-DeMeester score with the Boix-Ochoa score was still high (r = 0.94, P <  < 0.01, 95% 95% confidence interval). As considered until now, the Boix-Ochoa score is the most accurate score to be used in pediatrics for the diagnosis of GERD. The use of the different scores-Boix-Ochoa, DeMeester, Johnson-DeMeester-showed a high sensitivity and specificity of the pH-metry measurements applied to the study lot, but the last score has a higher risk of false-negative results.

摘要

24小时食管pH测定法是诊断胃食管反流病(GERD)最广泛使用的方法。该研究比较了24小时食管pH测定过程中获得的不同评分。一项为期5年的回顾性研究,纳入了罗马尼亚东北部一家儿科胃肠病区域中心收治的234名儿童(年龄在1个月至18岁之间),这些儿童疑似患有GERD。他们接受了24小时食管pH测定,并对获得的评分(博伊克斯 - 奥乔亚评分、德梅斯特评分、约翰逊 - 德梅斯特评分)进行了比较。在234名儿童中,172名(73.50%)博伊克斯 - 奥乔亚评分呈阳性,62名(26.50%)博伊克斯 - 奥乔亚评分正常(<11.99)。根据德梅斯特评分,149名儿童(63.68%)为阳性,85名(36.32%)为阴性。德梅斯特评分与博伊克斯 - 奥乔亚评分的相关性非常高(r = 0.978,P << 0.01,95%置信区间)。考虑约翰逊 - 德梅斯特评分,120例(51.28%)患有GERD,114例(48.72%)未患GERD。约翰逊 - 德梅斯特评分与博伊克斯 - 奥乔亚评分的相关性仍然很高(r = 0.94,P << 0.01,95%置信区间)。到目前为止,博伊克斯 - 奥乔亚评分是儿科用于诊断GERD最准确的评分。使用不同的评分——博伊克斯 - 奥乔亚评分、德梅斯特评分、约翰逊 - 德梅斯特评分——显示应用于该研究群体的pH测定具有较高的敏感性和特异性,但最后一个评分出现假阴性结果的风险更高。

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