Zaika Serhii, Paliy Iryna, Chernobrovyi Viacheslav, Ksenchyn Oleh Oleksandrovych
National Pirogov Memorial Medical University, Vinnytsya, Ukraine.
Prz Gastroenterol. 2020;15(4):323-329. doi: 10.5114/pg.2020.101561. Epub 2020 Dec 10.
INTRODUCTION: Clinical questionnaires have some limitations compared to instrumental diagnosis of gastroesophageal reflux disease (GERD), but clinical diagnosis of GERD based on typical symptoms is pragmatic and well-established by societal guidelines. AIM: To study the diagnostic value and provide comparative analysis of GerdQ and GSRS questionnaires regarding the GERD diagnostics based on a comparison of the questionnaires with the results of intraluminal oesophageal impedance-pH monitoring in Ukraine. MATERIAL AND METHODS: Twenty-eight patients (11 men and 17 women with a mean age of 47 ±2.4 years and a mean body mass index of 25.6 ±1.1 kg) filled in the GerdQ and GSRS questionnaires and underwent 24-hour multichannel intraluminal oesophageal impedance-pH monitoring. RESULTS: The GerdQ questionnaire showed a significantly strong correlation between the total score of the questionnaire and the key indicators of 24-hour impedance-pH monitoring: AET ( = 0.793), acid reflux episodes ( = 0.796), and liquid reflux episodes ( = 0.730). Correlation of reflux syndrome according to the GSRS questionnaire was established between the acid reflux episodes ( = 0.530), the episodes of all fluid refluxes ( = 0.598), and AET ( = 0.560), but the strength of the correlation relationships is weaker. The GerdQ questionnaire showed a sensitivity of 78.6%, specificity of 92.9%, and accuracy (diagnostic efficiency) of 85.7%. CONCLUSIONS: The use of the GerdQ questionnaire for the diagnosis of GERD is optimal in everyday practice for deciding whether to prescribe "ex juvantibus" therapy or whether to use instrumental examination methods (upper endoscopy, oesophageal pH monitoring, oesophageal impedance-pH monitoring).
引言:与胃食管反流病(GERD)的仪器诊断相比,临床问卷存在一些局限性,但基于典型症状的GERD临床诊断是实用的,并且已被社会指南充分确立。 目的:通过将问卷结果与乌克兰腔内食管阻抗 - pH监测结果进行比较,研究GerdQ和GSRS问卷在GERD诊断方面的诊断价值并提供比较分析。 材料与方法:28例患者(11名男性和17名女性,平均年龄47±2.4岁,平均体重指数25.6±1.1kg)填写了GerdQ和GSRS问卷,并接受了24小时多通道腔内食管阻抗 - pH监测。 结果:GerdQ问卷显示问卷总分与24小时阻抗 - pH监测的关键指标之间存在显著强相关性:酸暴露时间(AET)(r = 0.793)、酸反流发作次数(r = 0.796)和液体反流发作次数(r = 0.730)。GSRS问卷的反流综合征与酸反流发作次数(r = 0.530)、所有液体反流发作次数(r = 0.598)和AET(r = 0.560)之间建立了相关性,但相关关系的强度较弱。GerdQ问卷的敏感性为78.6%,特异性为92.9%,准确性(诊断效率)为85.7%。 结论:在日常实践中,使用GerdQ问卷诊断GERD对于决定是否开具“对症”治疗或是否使用仪器检查方法(上消化道内镜检查、食管pH监测、食管阻抗 - pH监测)是最佳的。
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