Velanovich V, Karmy-Jones R
Department of Surgery, Henry Ford Hospital, Detroit, Michigan 48202-2689, USA.
Am Surg. 1998 Jul;64(7):649-53.
The Gastroesophageal Reflux Disease-Health-Related Quality of Life (GERD-HRQL) scale is a reliable, valid, responsive, and practical measure of symptom severity in patients with GERD. This type of scale is needed to determine effects of treatments and their comparison. This study defines the relationship between the GERD-HRQL score and the physiologic parameters of esophagogastroduodenoscopy, esophageal manometry, and 24-hour esophageal pH monitoring. Fifty-five patients referred for surgical evaluation of GERD answered the GERD-HRQL, a nine-item ordinal-scaled questionnaire. They were evaluated with esophagogastroduodenoscopy, esophageal manometry, and 24-hour pH monitoring. The relationships among these results were determined by linear regression analysis. There were no correlations between lower esophageal sphincter (LES) and any of the pH monitoring parameters (all r < 0.25, P > 0.2), esophagitis grade (r = -0.21, P = 0.2), nor any individual GERD-HRQL item score nor total score (all r < 0.2, P > 0.11). There were correlations between all the pH monitoring parameters and esophagitis grade (all r > 0.6, P < 0.001), but not with any of the GERD-HRQL item scores or total score (r < 0.3, P > 0.15). Six of the nine items scores and the total GERD-HRQL score correlated with esophagitis grade (all r > 0.4, P < 0.01). LES pressure is a poor indicator of symptom severity, the amount of reflux, and esophageal mucosal damage. pH monitoring-measured reflux and GERD-HRQL-measured symptom severity correlate well with mucosal damage. If the goals of GERD treatment are to relieve symptoms and reverse mucosal damage, the GERD-HRQL score and 24-hour pH monitoring are better outcome measures than the LES pressure. In an era of cost containment, the GERD-HRQL may be an adequate outcome measure.
胃食管反流病健康相关生活质量（GERD - HRQL）量表是一种用于衡量胃食管反流病患者症状严重程度的可靠、有效、敏感且实用的工具。这种量表对于确定治疗效果及其比较是必要的。本研究定义了GERD - HRQL评分与食管胃十二指肠镜检查、食管测压和24小时食管pH监测等生理参数之间的关系。55名因胃食管反流病接受手术评估的患者回答了GERD - HRQL，这是一份包含九个项目的有序评分问卷。他们接受了食管胃十二指肠镜检查、食管测压和24小时pH监测。通过线性回归分析确定了这些结果之间的关系。食管下括约肌（LES）与任何pH监测参数之间均无相关性（所有r < 0.25，P > 0.2），与食管炎分级无相关性（r = -0.21，P = 0.2），与任何单个GERD - HRQL项目评分或总分也无相关性（所有r < 0.2，P > 0.11）。所有pH监测参数与食管炎分级之间存在相关性（所有r > 0.6，P < 0.001），但与任何GERD - HRQL项目评分或总分无相关性（r < 0.3，P > 0.15）。九个项目评分中的六个以及GERD - HRQL总分与食管炎分级相关（所有r > 0.4，P < 0.01）。LES压力对于症状严重程度、反流程度和食管黏膜损伤而言是一个较差的指标。pH监测所测的反流与GERD - HRQL所测的症状严重程度与黏膜损伤密切相关。如果胃食管反流病治疗的目标是缓解症状和逆转黏膜损伤，那么GERD - HRQL评分和24小时pH监测比LES压力是更好的疗效评估指标。在成本控制的时代，GERD - HRQL可能是一个足够的疗效评估指标。
