摘要
目的 研究胃食管反流性咳嗽（GERC）的社区患病率,建立GERC的社区诊断程序.方法 对入选的慢性咳嗽患者,在询问病史和查体的基础上,进行胸部X线检查、诱导痰细胞学检查、肺通气功能＋组胺激发试验、血嗜酸粒细胞分类计数、IgE、变应原皮试、鼻咽喉部检查、鼻窦X线平片或鼻咽镜等检查,筛选出疑诊GERC病例,进行反流病诊断问卷（RDQ）和食管外表现相关症状的调查并记录评分,评分≥12分者诊断为GERC,＜12分者行质子泵抑制剂（PPI）诊断性治疗,阳性诊断为GERC,然后统计GERC的社区患病率.结果 收集慢性咳嗽患者430例,经改良的Irwin等解剖学诊断程序筛选后疑诊GERC患者98例,占慢性咳嗽患者的22.79%;疑诊为GERC患者中67例RDQ评分≥12分,诊断为GERC,占68.37%,31例RDQ评分＜12分,占31.63%,两者食管外表现症状发生率比较差异有统计学意义（P＜0.01）;RDQ评分＜12分的疑诊GERC病例经PPI诊断性治疗后诊断为GERC 26例,阳性率83.87%;统计GERC的社区患病率占慢性咳嗽患者的21.63%（93/430）.结论 RDQ是诊断GERC的一个良好的筛选试验,PPI诊断性治疗对GERC的诊断敏感度高,建立GERC的社区诊断程序实为必要,可避免GERC的误诊、误治.
Objective To study community morbidity of gastroesophageal reflux cough （GERC）,and then establish its procedure of diagnosis. Methods For the patients with chronic cough, on the basis of inquiring medical history and physical examination, chest radiograph, induced sputum, pulmonary ventilation function and airway hyperresponsiveness, blood eosinophilic, IgE,allergens skin test, nose, throat examination,sinus X-ray or pharyngoscope etc was managed. On the basis of the results,patients suspecting GERC was screened out, and then RDQ was performed, extra-esophageal symptoms related performance was inquired and scores were recorded. The patients with scores ≥ 12 were diagnosed as GERC; the patients with scores 〈 12 were performed diagnosing treatment with proton pump inhibitor （PPI）,and patients with positive results were diagnosed as GERC. The materials was analyzed statistically. Results The patients with chronic cough were 430 cases,and the community morbidity of GERC was 22.79%（98/430）. RDQ ≥12 scores was 68.37%（67/98）,and RDQ 〈 12 scores was 31.63%（31/98）.There was significant difference in extra-esophagus manifestation （P 〈0.01）;26 cases with RDQ 〈12 scores were diagnosed as GERC （83.87%）,and the rate of GERC in chronic cough was 21.63% （93/430）. Conclusions RDQ is a favourable screening test in diagnosing GERC. PPI diagnosing treatment has high sensibility in GERC. It is necessary to establish community diagnosis procedure.
出处
《中国医师进修杂志》
2010年第34期33-36,共4页
Chinese Journal of Postgraduates of Medicine
关键词
咳嗽
胃食管反流
患病率
反流性疾病问卷
Cough
Gastroesophageal reflux
Prevalence
Reflux disease questionnaire
