婴幼儿胃食管反流病问卷的诊断价值评价  

Diagnostic value of gastroesophageal reflux disease questionnaire in infants and young children

作　　者：方玉蓉[1] 周诗琼[1] 胡燕华[1] 王莹[1] 梅红[1] 

机构地区：[1]武汉市妇女儿童医疗保健中心呼吸内科,湖北武汉430016

出　　处：《中国实用儿科杂志》2015年第5期368-371,共4页Chinese Journal of Practical Pediatrics

基　　金：武汉市卫生科技项目(编号:WG11D01)

摘　　要：目的评价胃食管反流病问卷（GERD-Q）在婴幼儿胃食管反流病（GERD）诊断中的价值。方法 2011年1月至2014年2月武汉市妇女儿童医疗保健中心疑似GERD症状的婴儿148例,幼儿87例,通过24 h食管动态p H监测、上消化道碘水造影检查确定GERD的诊断,确诊者为GERD组,排除诊断者为对照组。所有患儿均完成GERD-Q量表调查。采用SPSS17.0统计软件,绘制GERD-Q综合症状评分（CSS）的受试者工作特征（ROC）曲线。结果 （1）在1个月至〈1岁婴儿及1-3岁幼儿两个年龄段中,GERD组CSS评分均高于对照组（P〈0.000）。（2）1个月至〈1岁婴儿CSS评分的ROC曲线下面积（AUC）为0.914,当CSS评分临界值为70.5分时,其Youden指数最大值达0.692,诊断敏感度为77.3%,特异度为91.9%。1-3岁幼儿CSS评分的ROC曲线AUC为0.895,当CSS评分临界值为26.5分时,其Youden指数最大值达0.741,诊断敏感度为92.9%,特异度为81.2%。结论分别以70.5分和26.5分作为婴儿和幼儿CSS评分诊断临界值,诊断GERD的敏感度和特异度较高。年龄特异性GERD-Q量表是较理想的婴幼儿GERD辅助诊断工具。Objective To evaluate the value of gastroesophageal reflux disease questionnaire（GERD-Q）in the diagnosis of GERD in infants and young children. Methods From January 2011 to February 2014 in Wuhan Medical Health Center for Women and Children,148 infants and 87 young children with suspected GERD symptoms were enrolled. The diagnoses of GERD were made by 24 h esophageal pH monitoring and upper gastrointestinal hysterosalpingography. All cases had been surveyed with GERD-Q. Using SPSS17.0 statistical software to draw the receiver operating characteristic（ROC）curve of the composite symptom score（CSS）from GERD-Q,and comparison was made between groups with T-test. Results（1）Both in infants aged 1 months to 〈1 years and in young children aged 1-3 years,the CSS in the GERD group was higher than that in the control（P〈0.000）.（2）The area under curve（AUC）of CSS in infants was 0.914,while the critical value of CSS was 70.5,Youden index was up to 0.692,the sensitivity of diagnosis was 77.3%,and the specificity was 91.9%. The AUC of CSS in young children was 0.895,while the critical value of CSS was 26.5,Youden index was up to 0.741,the sensitivity of diagnosis was 92.9% and the specificity was 81.2%. Conclusion There is higher sensitivity and specificity with 70.5 or 26.5 as the diagnostic critical value of CSS respectively for the infants and for the young children. Age-specific GERD-Q scoring is a better auxiliary diagnosis tool for GERD in infants and in young children.

关 键 词：婴幼儿 胃食管反流病 问卷 诊断 

分 类 号：R72[医药卫生—儿科]