切换至 "中华医学电子期刊资源库"
高级检索
中华胃食管反流病电子杂志

中华胃食管反流病电子杂志 ›› 2017, Vol. 04 ›› Issue (01) : 27 -30. doi: 10.3877/cma.j.issn.1674-6899.2017.01.007

所属专题： 专题评论； 文献；

论著

Gerd Q评分量表在初步诊断食管反流病中的应用
玉素甫·买买提1, 赛甫丁·艾比布拉1, 麦麦提艾力·麦麦提明2, 克力木·阿不都热依木2,†()   
  1. 1. 830000　乌鲁木齐，新疆维吾尔自治区人民医院微创、疝与腹壁外科
    2. 830000　乌鲁木齐，新疆维吾尔自治区人民医院微创、疝与腹壁外科；830001　乌鲁木齐，新疆医科大学临床学院
  • 收稿日期:2017-01-09 出版日期:2017-02-15
  • 通信作者: 克力木·阿不都热依木

The application of Gerd Q scoring in the preliminary diagnosis of gastroesophageal reflux disease

Maimaiti Yusufu1, Aibibula Saifuding1, Maimaitiming Maimaitiaili2, Abudureyimu Kelimu2,†()   

  1. 1. Department of minimally invasive surgery, hernia and abdominal wall surgery, People′s Hospital of Xinjiang Uyhgur Autonomous Region, Urumqi, 830000, China
    2. Department of minimally invasive surgery, hernia and abdominal wall surgery, People′s Hospital of Xinjiang Uyhgur Autonomous Region, Urumqi, 830000, China; Department of clinical department , People′s Hospital of Xinjiang Uygur Autonomous Region, Urumuqi 830001, China
  • Received:2017-01-09 Published:2017-02-15
  • Corresponding author: Abudureyimu Kelimu
  • About author:
    Corresponding author: Kelimu, Email:
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

玉素甫·买买提, 赛甫丁·艾比布拉, 麦麦提艾力·麦麦提明, 克力木·阿不都热依木. Gerd Q评分量表在初步诊断食管反流病中的应用[J]. 中华胃食管反流病电子杂志, 2017, 04(01): 27-30.

Maimaiti Yusufu, Aibibula Saifuding, Maimaitiming Maimaitiaili, Abudureyimu Kelimu. The application of Gerd Q scoring in the preliminary diagnosis of gastroesophageal reflux disease[J]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2017, 04(01): 27-30.

目的

评价胃食管反流病调查评分量表(Gerd Q)对胃食管反流病(GERD)患者初步诊断中的应用价值。

方法

采用随机抽样法选取收集自2015年6月～2016年6月，在新疆维吾尔自治区人民医院微创、疝与腹壁外科疑似GERD患者350例，应用Gerd Q评分量进行评分，并进行专科处理，进一步完善内镜、食管24 h PH检测和(或)质子泵抑制剂(proton pump inhibitor，PPI)诊断实验等进一步确诊，并与Gerd Q值进行比较，最后计算出诊断GERD的临界值进而分析Gerd Q量表在诊断GERD中的价值。

结果

GERD患者中Gerd Q积分主要集中于7～14分，非GERD组主要集中于7分以下，差异有统计学意义(P<0.05)；Gerd Q诊断临界值升高后，其灵敏度逐渐降低，特异度逐渐升高，Gerd Q评分量表以8分为临界值时，ROC曲线下面积为0.802，其敏感性和特异性分别为77.50%和87.31%，Youden指数0.648，对GERD患者诊断的阳性符合率为77.72%，阴性符合率为87.8%。

结论

Gerd Q量表是GERD的良好筛查工具之一，敏感性和特异性较高，可用于GERD的初步诊断。

关键词: 胃食管反流, 初步诊断
Objective

To evaluate the application of Gerd Q in the diagnosis of gastroesophageal reflux disease(GERD)in patients with gastroesophageal reflux disease.

Methods

Patients were selected from June 2015 to June 2016 in People′s Hospital of Xinjiang Uygur Autonomous Region who was suspected as GERD and ask them to fill the Gerd Q. All patients received Gerd Q questionnaire survey, gastroscope, 24h pH monitoring of esophageal and/or proton pump inhibitor(PPI)treatment.gastroscope, 24h pH monitoring of esophageal and/or PPI treatment were regarded as golden diagnosis standards.The results were compared with Gerd Q scores, in order to calculate the diagnostic sensitivity, specificity and accuracy of Gerd Q.

Results

Gerd Q scores were mainly concentrated in 7~14 points, and non GERD group mainly concentrated below 7 points, after the Gerd Q diagnostic threshold increases, the sensitivity decreases and the specificity increases, when the area under the ROC curve is 0.802 the best diagnostic sensitivity and specificity were 77.5% and 87.3% respectively when score 8 was set as the critical value for the Gerd Q, The Youden index reached a maximum of 0.648.The positive coincidence rate of diagnosis in patients with GERD was 77.72%, and the negative coincidence rate was 87.8%.

Conclusion

The Gerd Q is a good screening test for the diagnosis of GERD, the preliminary diagnosis rate is high, which can be used as a noninvasive, simple, easy, economical and effective method for the clinical diagnosis of GERD.

Key words: Gastroesophageal reflux, Preliminary diagnosis
表1 Gerd Q评分量表[8]
回忆过去7天 0 d 1 d 2-3 d 4-7 d
烧灼感(烧心) 0 1 2 3
胃内容物反流至喉咙或口腔 0 1 2 3
上腹中央疼痛 3 2 1 0
恶心 3 2 1 0
因反流而睡眠障碍 0 1 2 3
使用OTC*药(缓解烧心反流的药) 0 1 2 3
图1 GerdQ诊断受试者工作特征曲线(n＝350例)
表2 Gerd Q评分与金标准结果比较(例)
Gerd Q评分 内镜、24 h食管pH、PPI 合计
GERD 非GERD
≥8 157 18 175
<8 45 130 175
合计 202 148 350
1
Katz P O，Gerson L B，Vela M F．Guidelines for the diagnosis and management of gastroesophageal reflux disease[J]．American Journal of Gastroenterology，2013，108(3):308-328.
2
Fujiwara Y，Higuchi K，Watanabe Y，et al.Prevalence of gastroesophageal reflux disease and gastroesophageal reflux disease symptoms in Japan[J]．Journal of Gastroenterology & Hepatology，2005，20(1):26-29.
3
Revicki D A，Wood M，Wiklund I，et al.Reliability and validity of the Gastrointestinal Symptom Rating Scale in patients with gastroesophageal reflux disease[J]．Quality of Life Research，1997，7(1):75-83.
4
Jones R，Coyne K，Wiklund I．The gastro-oesophageal reflux disease impact scale：a patient management tool for primary care[J]．Aliment Pharmacol Ther，2007，25(12):1451-1459.
5
Shaw M，Dent J，Beebe T，et al.The Reflux Disease Questionnaire：a measure for assessment of treatment response in clinical trials[J]．Health Qual Life Outcomes，2008，30(3):6-31.
6
王连芬，郑长青，林连捷，等．Gerd Q量表在胃食管反流病中的诊断价值[J]．世界华人消化杂志，2011(18):1941-1945.
7
沈奕，李兴华，钟捷，等．胃食管反流病调查问卷的诊断价值评价[J]．中国临床医学，2013，20(4):541-543.
8
Dent J，Jones R，Vakil N，et al.A management strategy for GERD based on the Gastroesophageal reflux disease questionnaire(Gerd Q)[J]．Scandinavian Journal of Gastroenterology，2008，43:34-35.
9
陈旻湖．重视GERD症状诊断，完善GERD诊疗流程[J]．浙江医学，2015，37(23):1883-1884.
10
Shaw M J，Talley N J，Beebe T J，et al.Initial validation of a diagnostic questionnaire for gastroesophageal reflux disease[J]．American Journal of Gastroenterology，2001，96(1):52-57.
11
Jones R，Junghard O，Dent J，et al.Development of the GerdQ，a tool for the diagnosis and management of gastro-oesophageal reflux disease in primary care[J]．Alimentary Pharmacology & Therapeutics，2009，30(10):1030-1038.
12
Vakil N，Dent J，Jones R，et al.T2002 The Accuracy and Predictors of a Clinical Diagnosis of GERD By Family Practitioners and Gastroenterologists[J]．Gastroenterology，2008，134(4):A-598-A-598.
13
王志，张成，王俭，等．Gerd Q量表在胃食管反流病诊断中的应用[J]．中华胃食管反流病电子杂志，2014(1):36-38.
14
唐小波，王亚雷，许建明．胃食管反流病问卷在胃食管反流病诊断中的价值[J]．安徽医科大学学报，2011，46(3):275-278.
[1] 李世红, 侯康. 腹腔镜食管裂孔疝补片修补术联合胃底折叠术(Nissen)[J]. 中华普通外科学文献(电子版), 2023, 17(05): 365-365.
[2] 王鸿彬, 何晓, 吴菁宙. 腹腔镜近端胃切除术中背驮式间置空肠单通道重建术在AEG手术的安全性及抗反流效果研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(05): 526-529.
[3] 赵国栋, 施喆, 孙树刚, 薛亮, 王晓辉, 杨勇. 两种消化道重建方案的腹腔镜近端胃切除术后患者胃内压变化的对比研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(03): 292-295.
[4] 贾卓奇, 周维茹, 张勇, 张广健, 付军科. 达·芬奇机器人与腹腔镜食管裂孔疝修补术的对比研究[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(04): 410-414.
[5] 李亮, 洪楚原, 李明哲, 郝腾飞, Chongkuo Zi. 胃食管结合部抗反流机制探讨[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(01): 6-8.
[6] 张继舜, 陈思旭, 钱洁, 尚占民, 郝建宇. 平均夜间基线阻抗对食管外症状胃食管反流病的临床诊断价值[J]. 中华胃肠内镜电子杂志, 2023, 10(02): 97-102.
[7] 吕昆明, 王沙沙, 万军, 令狐恩强. 胃食管反流病与特发性肺纤维化关系的研究进展[J]. 中华胃肠内镜电子杂志, 2023, 10(02): 121-124.
[8] 王擎, 王冠峰, 陈星. 胃食管阀瓣的Hill分级在胃食管反流病中的应用价值[J]. 中华胃肠内镜电子杂志, 2023, 10(02): 125-130.
[9] 王翊钊, 刘阳, 叶淑君, 马连君. 胃食管反流病治疗的研究进展[J]. 中华胃肠内镜电子杂志, 2023, 10(01): 57-61.
[10] 陆洪鹏, 袁芯, 郑树灏, 刘怡, 徐磊. 慢性咳嗽与胃食管反流病：双向两样本孟德尔随机化研究[J]. 中华胃食管反流病电子杂志, 2023, 10(02): 59-64.
[11] 范勇, 张利昉, 杨美琳. 改良经口内镜下贲门缩窄术治疗胃食管反流病效果分析[J]. 中华胃食管反流病电子杂志, 2023, 10(02): 65-68.
[12] 文明, 熊英, 艾克拜尔·艾力, 克力木·阿不都热依木. 质子泵抑制剂治疗期间焦虑对胃食管反流病疗效的影响[J]. 中华胃食管反流病电子杂志, 2023, 10(02): 90-95.
[13] 李鹏, 刘国祥, 李汝红. 经口内镜下贲门缩窄术治疗胃食管反流病的研究进展[J]. 中华胃食管反流病电子杂志, 2023, 10(02): 96-99.
[14] 买买提·依斯热依力, 尹强, 尹海龙, 董雨微, 王永康, 克力木·阿不都热依木, 阿吉艾克拜尔·艾萨. 传统医药治疗胃食管反流病的研究进展[J]. 中华胃食管反流病电子杂志, 2023, 10(02): 100-104.
[15] 闫文貌, 孙海涛, 白日星. 胃袖状切除相关术式中应重视胃窦部解剖与生理功能[J]. 中华肥胖与代谢病电子杂志, 2023, 09(03): 161-164.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号