3种方法诊断儿童咽喉反流的比较研究  

Comparative study of three methods in the diagnosis of laryngopharyngeal reflux in children

作　　者：齐智伟[1] 张淑君[1] 张学红[1] 张宇丽[1] 陆鸿略[1] QI Zhiwei;ZHANG Shujun;ZHANG Xuehong;ZHANG Yuli;LU Honglue(Department of Otorhinolaryngology,Affiliated Hospital of Chengde Medical College,Chengde,067000,China)

机构地区：[1]承德医学院附属医院耳鼻咽喉科,河北承德067000

出　　处：《临床耳鼻咽喉头颈外科杂志》2020年第4期343-345,350,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨RSI和RFS量表评分、胃蛋白酶检测、pH监测在诊断儿童咽喉反流(LPR)的一致性、灵敏度及特异度。方法:门诊诊断可疑LPR的患儿76例,最后确诊为LPR的患儿65例,对其同时进行RSI和RFS量表评分、胃蛋白酶检测及Dx-pH监测,检验3种方法的诊断一致性,并计算其灵敏度和特异度。结果:76例可疑LPR患者中胃蛋白酶检测、24hDx-pH监测、RSI和RFS量表诊断LPR灵敏度分别为95.31%、66.15%和84.62%,特异度分别为100%、81.82%和72.73%。胃蛋白酶检测与RSI和RFS量表诊断结果一致性良好(Kappa>0.75),胃蛋白酶检测与24hDx-pH监测诊断结果一致性一般(Kappa=0.467),24hDx-pH监测与RSI和RFS量表诊断结果一致性一般(Kappa=0.446)。结论:胃蛋白酶检测客观、经济无创、患儿无不适感,可作为诊断儿童LPR的可靠指标,易于临床推广。Objective:To compare the consistency of RSI and RFS,pepsin detection and 24hDx-pH monitoring in the diagnosis of laryngopharyngeal reflux(LPR)in children.Method:A retrospective analysis was made of 76children with suspicious LPR.A total of 65children with suspicious LPR were finally diagnosed.RSI and RFS scales,pepsin detection and Dx-pH monitoring were performed simultaneously.The diagnostic consistency of the three methods was tested,and the sensitivity and specificity were calculated.Result:The sensitivity of pepsin detection,24hDx-pH monitoring,RSI and RFS in the diagnosis of LPR in 76suspected LPR patients were 95.31%,66.15%and 84.62%,and the specificity were 100%,81.82%and 72.73%.The pepsin detection was well consistent with the scale(Kappa>0.75),pepsin detection and 24hDx-pH monitoring were in medium consistency(Kappa=0.467),and 24hDx-pH monitoring and scale were in medium consistency(Kappa=0.446).Conclusion:Pepsin detection can be used as a reliable index for the diagnosis of LPR in children.It is objective,economical,non-invasive,comfortable and easy to spread.

关 键 词：咽喉反流 胃蛋白酶 PH监测 RSI量表 RFS量表 

分 类 号：R766.5[医药卫生—耳鼻咽喉科]