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背景:关于胃食管反流病(GERD)的临床诊断路径,目前尚未达成共识。目的:探讨简便易行、可靠的GERD临床诊断路径。方法:对初诊时有反酸、烧心等症状者行反流性疾病问卷(RDQ)调查,分值≥8者行"C-尿素呼气试验和胃镜检查,并予递减法抑酸治疗或在根除幽门螺杆菌(H.pylori)感染的基础上行递减法治疗。16周后复行RDQ调查,并随访6个月以上。结果:共118例患者符合纳入标准。RDQ分值≥12、可诊断为GERD者86例(72.9%),RDQ均值为19.08分,烧心症状的频率和程度均高于其他症状。RDQ分值≥12者内镜诊断为反流性食管炎(RE)且H.pylori阳性的概率为57.0%(49/86),RDQ分值<12者内镜下无RE表现且H.pylori阴性的可能性为37.5%(12/32)。RDQ分值≥12者16周递减法抑酸治疗的有效率为95.3%(82/86),随访过程中31.4%(27/86)的患者仍需间断服用H_2受体拮抗剂。结论:以RDQ量表初诊GERD有一定可行性,如与内镜检查和H.pylori检测联合应用,对GERD的处理更具指导意义。
Background: There is currently no consensus on the clinical diagnosis of gastroesophageal reflux disease (GERD). Objective: To explore a simple and reliable GERD clinical diagnosis path. Methods: A retrospective questionnaire (RDQ) was performed on patients who had symptoms such as acid reflux and heartburn when the patients were newly diagnosed. Patients with a score of 8 or higher underwent C-urea breath test and gastroscopy, The results of retrograde RDQ investigation after 16 weeks of follow-up were more than 6 months.Results: A total of 118 patients met the inclusion criteria.RDQ score≥12, which can be diagnosed as 86 cases (72.9%) had GERD, mean RDQ was 19.08 points, and the frequency and degree of heartburn symptoms were higher than other symptoms.The diagnosis of reflux esophagitis (RE) and H.pylori positive (57.0%, 49/86), the RDQ score <12 was 37.5% (12/32) for endoscopy-free RE and negative for H.pylori. The effective rate of antacid therapy was 95.3% (82/86), and 31.4% (27/86) of the patients were still taking H_2 receptor antagonists intermittently during the follow-up.Conclusion: There is a certain feasibility of newly diagnosed GERD with RDQ scale, If combined with endoscopy and H.pylori detection, the treatment of GERD is more instructive.