Qi Z W, Zhang S J, Zhang Y L, Su R F, Huang Y Y
Department of Otolaryngology, the Affiliated Hospital of Chengde Medical University, Chengde, 067000, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Nov;32(22):1711-1713. doi: 10.13201/j.issn.1001-1781.2018.22.007.
To explore the diagnostic value and optimal diagnostic threshold of reflux symptom index(RSI) in allergic patients with laryngopharyngeal reflux. All the adult allergic patients with respiratory tract symptoms completed the RSI with the consent of the patients. A total of 150 patients with RSI＞13 were screened out. The LPR patients were confirmed by 24 h pH-metry of pharyngo-laryngoesophageal (allergic group). The same number of non allergic laryngeal reflux patients were selected as control group (non allergic group). The ratio of RSI＞13 to LPR was calculated. The total score of RSI and each score were compared between the allergic group and the non allergic group. ROC curve was used to analyze the highly suspicious RSI score thresholds for patients with reflux laryngitis. Only 53(35.33%) of 150 patients with RSI＞13 were diagnosed as LPR after 24 h pH-metry test in allergic patients. Among the 9 symptoms of RSI, the scores of 6 symptoms in allergic group were significantly higher than those in non allergic group(<0.05). The average RSI score of allergic group was 23.57±3.17. The average RSI score of non allergic group was 17.57±2.64. The total score of allergic group was higher than that of non allergic group(<0.05). According to the RSI score ROC curve of allergic group, the area under 95% confidence interval curve was 0.815. RSI had certain diagnostic accuracy for allergic patients with LPR. The best critical value of RSI score for allergic patients with LPR was 18, the sensitivity was 94.3%, and the specificity was 56.7%. RSI can be used to screen allergic patients with LPR, diagnostic score threshold RSI＞18 points, has a certain diagnostic accuracy.
探讨反流症状指数（RSI）在变应性咽喉反流患者中的诊断价值及最佳诊断阈值。所有有呼吸道症状的成年变应性患者在获得患者同意后完成RSI评估。共筛选出150例RSI＞13的患者。通过咽喉食管24小时pH监测确诊LPR患者（变应性组）。选取相同数量的非变应性喉反流患者作为对照组（非变应性组）。计算RSI＞13与LPR的比例。比较变应性组和非变应性组RSI的总分及各项得分。采用ROC曲线分析反流性喉炎患者高度可疑的RSI评分阈值。变应性患者中，150例RSI＞13的患者经24小时pH监测后，仅53例（35.33%）被诊断为LPR。在RSI的9项症状中，变应性组6项症状的得分显著高于非变应性组（P＜0.05）。变应性组RSI平均得分为23.57±3.17。非变应性组RSI平均得分为17.57±2.64。变应性组总分高于非变应性组（P＜0.05）。根据变应性组RSI评分ROC曲线，95%置信区间曲线下面积为0.815。RSI对变应性LPR患者有一定诊断准确性。变应性LPR患者RSI评分的最佳临界值为18，敏感性为94.3%，特异性为56.7%。RSI可用于筛查变应性LPR患者，诊断评分阈值RSI＞18分，有一定诊断准确性。
