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胃充盈超声联合 GerdQ 量表对胃食管反流病的诊断及病因分析。

Diagnosis and Etiological Analysis of Gastroesophageal Reflux Disease by Gastric Filling Ultrasound and GerdQ Scale.

机构信息

Department of Physical Diagnostics, West Hospital District of Qingdao Multicipal Hospital, Qingdao 266002, China.

Department of Ultrasound, the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250000, China.

出版信息

J Healthc Eng. 2021 Nov 15;2021:5629067. doi: 10.1155/2021/5629067. eCollection 2021.

Abstract

OBJECTIVE

To investigate the diagnosis and etiological analysis of GERD by gastric filling ultrasound and GerdQ scale.

METHODS

The clinical data of 100 suspected GERD patients were selected for retrospective analysis. The selection time was from June 2016 to June 2019. According to the gold standard (endoscopy) results, they were divided into the gastroesophageal reflux group (positive,  = 62) and the nongastroesophageal reflux group (negative,  = 38); both gastric filling ultrasound and GerdQ scale examination were performed to compare the positive predictive value and negative predictive value, evaluate the abdominal esophageal length, His angle, and GerdQ scale score, and analyze the AUC value, sensitivity, specificity, and Youden index of His angle, length of abdominal esophagus, combined ultrasound parameters, and GerdQ scale in the diagnosis of GERD.

RESULTS

100 patients with suspected GERD were diagnosed as GERD by endoscopy; in a total of 62 cases, the percentage was 62.00%. Among them, 28 cases were caused by the abnormal structure and function of the antireflux barrier, accounting for 45.16%, 18 cases were caused by the reduction of acid clearance of the esophagus, accounting for 29.03%, and 16 cases were caused by the weakening of the esophageal mucosal barrier, accounting for 25.81%. After ultrasound detection, the positive predictive value was 88.71% and the negative predictive value was 81.58%; after the GerdQ scale was tested, the positive predictive value was 71.43% and the negative predictive value was 54.05%. The length of the abdominal esophagus in the gastroesophageal reflux group was lower than that of the nongastroesophageal reflux group, while the scores of His angle and GerdQ scale were higher than those in the gastroesophageal reflux group ( < 0.05). ROC curve analysis showed that the AUC values of His angle, length of abdominal esophagus, combined ultrasound parameters, and GerdQ scale to diagnose GERD were 0.957, 0.861, 0.996, and 0.931 ( < 0.05), their sensitivity was 93.5%, 98.40%, 98.40%, and 90.30%, and the specificity was 92.10%, 63.20%, 100.00%, and 92.10%, respectively.

CONCLUSION

Both gastric filling ultrasound and GerdQ scale have a certain application value in the diagnosis of GERD, but the former has a higher accuracy rate, and it is more common for gastroesophageal reflux caused by abnormal structure and function of antireflux barrier in etiological analysis.

摘要

目的

通过胃充盈超声和 GerdQ 量表探讨 GERD 的诊断和病因分析。

方法

回顾性分析 2016 年 6 月至 2019 年 6 月收治的 100 例疑似 GERD 患者的临床资料。根据金标准(内镜)结果将其分为胃食管反流组(阳性,n=62)和非胃食管反流组(阴性,n=38);两组均进行胃充盈超声和 GerdQ 量表检查,比较阳性预测值和阴性预测值,评估腹段食管长度、His 角和 GerdQ 量表评分,并分析 His 角、腹段食管长度、联合超声参数和 GerdQ 量表在 GERD 诊断中的 AUC 值、灵敏度、特异性和 Youden 指数。

结果

100 例疑似 GERD 患者经内镜诊断为 GERD;共 62 例,占比 62.00%。其中,28 例由抗反流屏障结构和功能异常引起,占 45.16%,18 例由食管酸清除减少引起,占 29.03%,16 例由食管黏膜屏障减弱引起,占 25.81%。超声检测的阳性预测值为 88.71%,阴性预测值为 81.58%;GerdQ 量表检测的阳性预测值为 71.43%,阴性预测值为 54.05%。胃食管反流组的腹段食管长度低于非胃食管反流组,His 角和 GerdQ 量表评分高于非胃食管反流组(<0.05)。ROC 曲线分析显示,His 角、腹段食管长度、联合超声参数和 GerdQ 量表诊断 GERD 的 AUC 值分别为 0.957、0.861、0.996 和 0.931(<0.05),灵敏度分别为 93.5%、98.40%、98.40%和 90.30%,特异性分别为 92.10%、63.20%、100.00%和 92.10%。

结论

胃充盈超声和 GerdQ 量表在 GERD 诊断中均有一定的应用价值,但前者准确性更高,病因分析中更常见的是抗反流屏障结构和功能异常引起的胃食管反流。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8735/8608510/3ff62bbff783/JHE2021-5629067.001.jpg

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