Qi Zhiwei, Zhang Yuli, Su Ruifeng, Niu Ruifeng, Liu Chunli
Department of Otorhinolaryngology，Affiliated Hospital of Chengde Medical College，Chengde，067000，China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020 Feb;34(2):170-172. doi: 10.13201/j.issn.1001-1781.2020.02.017.
The aim of this study is to determine the accuracy of RSI and RFS in the diagnosis of hypopharyngeal reflux （LPR）, the scores of RSI and RFS were compared in different age groups. To explore the RSI and RFS scoring thresholds for diagnosis of LPR in different age groups. From January 2017 to March 2019, 258 patients with suspected LPR in our hospital outpatient clinic completed the RSI and RFS scales. According to their age, 258 patients with RSI>13 and RFS>7 were selected. They were divided into group A （18-<40 years, =86）, group B （40-<60 years, =107） and group C （≥60 years, =65）. The diagnosis was confirmed by 24 h pH-metry. The diagnostic rate, RSI and RFS scores were compared among the three groups. ROC curve was used to analyze the optimal thresholds for the diagnosis of LPR by RSI and RFS scores. Among the three groups, group C had the highest diagnostic rate（93.85%）. There was no significant difference in RFS score among the three groups （>0.05）, RSI score was significantly different （<0.05）, RSI score of group A and group B was higher than that of group C （<0.05）. According to ROC analysis, the best RSI cutoffs for diagnosing LPR in group C was 11, and the area under the ROC curve was 0.866. The RSI score is a good criterion for the diagnosis of LPR. The diagnostic threshold of RSI in elderly patients is different from that in young patients. For elderly patients, the diagnostic threshold for the recommended RSI score is 11.
本研究的目的是确定反流症状指数（RSI）和反流发现评分（RFS）在诊断下咽反流（LPR）中的准确性，比较不同年龄组的RSI和RFS评分。探索不同年龄组诊断LPR的RSI和RFS评分阈值。2017年1月至2019年3月，我院门诊258例疑似LPR患者完成了RSI和RFS量表。根据年龄，选取258例RSI>13且RFS>7的患者。将他们分为A组（18 - <40岁，n = 86）、B组（40 - <60岁，n = 107）和C组（≥60岁，n = 65）。通过24小时pH监测确诊。比较三组的诊断率、RSI和RFS评分。采用ROC曲线分析RSI和RFS评分诊断LPR的最佳阈值。三组中，C组诊断率最高（93.85%）。三组RFS评分无显著差异（>0.05），RSI评分有显著差异（<0.05），A组和B组的RSI评分高于C组（<0.05）。根据ROC分析，C组诊断LPR的最佳RSI截断值为11，ROC曲线下面积为0.866。RSI评分是诊断LPR的良好标准。老年患者的RSI诊断阈值与年轻患者不同。对于老年患者，推荐的RSI评分诊断阈值为11。
