GerdQ评分与反流性食管炎严重程度相关性的研究

摘要

背景:胃食管反流病问卷(GerdQ)在胃食管反流病(GERD)的诊断中具有较高的应用价值.反流性食管炎(RE)是GERD的临床类型之一,患者存在内镜下食管黏膜损伤.目的:探讨GerdQ评分与RE严重程度之间的关系.方法:连续纳入2014年8月—2015年12月在新疆维吾尔自治区人民医院消化科就诊、有典型反流相关症状并符合纳入标准的患者,行一般资料和GerdQ量表调查以及上消化道内镜检查,采用洛杉矶分类系统对RE严重程度进行内镜分级.结果:共1554例患者纳入研究,其中RE组664例,非RE对照组890例.RE组男性所占比例显著高于对照组(50.9%对37.1%,P<0.05),维吾尔族RE检出率显著高于汉族以及其他少数民族(48.5%对40.5%和39.3%,P均<0.05).GerdQ评分在0~14分之间时,RE患者所占比例随评分增高而增加,评分0~2分、3~7分、8~10分、11~14分者中RE患者分别占0%、19.7%、50.1%和51.7%.RE组平均GerdQ评分显著高于对照组(9.95 ± 2.76对9.09 ± 3.33,P<0.05),且GerdQ评分与RE严重程度呈显著正相关(r=0.243,P<0.05).进一步按民族进行分组分析,GerdQ评分与RE严重程度之间的相关性仍然存在.结论:GerdQ对RE的诊断具有指导意义,评分≥8分对RE与非RE有一定区分价值,且GerdQ评分可反映RE严重程度.%Background:Gastroesophageal reflux disease questionnaire(GerdQ)is a potentially useful tool for diagnosis of gastroesophageal reflux disease(GERD). Reflux esophagitis(RE)is a clinical type of GERD characterized by endoscopic mucosal injury of esophagus. Aims:To study the correlation of GerdQ score with severity of RE. Methods:Patients with typical reflux-related symptoms and meeting the inclusion criteria were recruited consecutively from Department of Gastroenterology,the People's Hospital of Xinjiang Uygur Autonomous Region during Aug. 2014 to Dec. 2015. All patients recruited were asked to complete the GerdQ scoring scale,meanwhile,the demographic information was collected and an upper gastrointestinal endoscopy was performed. The severity of RE was graded endoscopically by Los Angeles classification system. Results:A total of 1 554 patients were enrolled in this study,664 with RE(RE group)and 890 without RE(control group). The proportion of males in RE group was significantly higher than those in control group (50.9% vs. 37.1%,P<0.05). The prevalence of RE was significantly higher in Uygur than in Han and other ethnics (48.5% vs. 40.5% and 39.3%,P all <0.05). The proportions of patients with RE rose up with the increase of GerdQ score in a cut-off range from 0-14(0%,19.7%,50.1% and 51.7% for 0-2,3-7,8-11 and 11-14,respectively). The mean GerdQ score was significantly higher in RE group than in control group(9.95 ± 2.76 vs. 9.09 ± 3.33,P<0.05), and GerdQ score was positively correlated with severity of RE(r=0.243,P<0.05). When stratified by nationality,the correlation of GerdQ score with severity of RE was unchanged. Conclusions:GerdQ is a useful complementary tool for the diagnosis of RE. A cut-off value of 8 might predict the presence of RE and the GerdQ score might reflect the disease severity.