The influence of age on the score of reflux symptom index scale and reflux finding score scale in the diagnosis of pharyngeal and laryngeal reflux
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摘要: 目的 比较不同年龄组患者反流症状指数量表(RSI)和反流体征指数量表(RFS)评分的差异，以确定RSI和RFS评分诊断喉咽反流(LPR)的准确性。探讨诊断LPR不同年龄组的RSI和RFS评分阈值。方法 2017-01-2019-03收治的疑似LPR患者，完成RSI和RFS量表，从中筛选出RSI > 13分和RFS > 7分的患者共258例，根据年龄分为A组(18~ < 40岁，86例)，B组(40~ < 60岁，107例)，C组(≥60岁，65例)。采用咽喉食管24 h pH值监测确诊。比较3组确诊率、RSI和RFS评分，ROC曲线分析RSI和RFS评分诊断LPR的最佳阈值。结果 3组患者中C组确诊率最高(93.85%)。确诊LPR的患者中，3组RFS评分差异无统计学意义(P > 0.05)，RSI评分差异有统计学意义(P < 0.05)，A组和B组RSI评分均高于C组(P < 0.05)。根据ROC曲线分析，C组患者诊断LPR的RSI最佳阈值为11分，ROC曲线下面积为0.866。结论 RSI评分作为诊断LPR的标准效果很好。老年患者RSI诊断阈值与年轻患者存在差异。对于老年患者，建议RSI评分的诊断阈值为11分。Abstract: Objective The aim of this study is to determine the accuracy of RSI and RFS in the diagnosis of hypopharyngeal reflux (LPR), the scores of RSI and RFS were compared in different age groups. To explore the RSI and RFS scoring thresholds for diagnosis of LPR in different age groups.Method From January 2017 to March 2019, 258 patients with suspected LPR in our hospital outpatient clinic completed the RSI and RFS scales. According to their age, 258 patients with RSI > 13 and RFS > 7 were selected. They were divided into group A (18- < 40 years, n=86), group B (40- < 60 years, n=107) and group C (≥60 years, n=65). The diagnosis was confirmed by 24 h pH-metry. The diagnostic rate, RSI and RFS scores were compared among the three groups. ROC curve was used to analyze the optimal thresholds for the diagnosis of LPR by RSI and RFS scores.Result Among the three groups, group C had the highest diagnostic rate(93.85%). There was no significant difference in RFS score among the three groups (P > 0.05), RSI score was significantly different (P < 0.05), RSI score of group A and group B was higher than that of group C (P < 0.05). According to ROC analysis, the best RSI cutoffs for diagnosing LPR in group C was 11, and the area under the ROC curve was 0.866.Conclusion The RSI score is a good criterion for the diagnosis of LPR. The diagnostic threshold of RSI in elderly patients is different from that in young patients. For elderly patients, the diagnostic threshold for the recommended RSI score is 11.
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Key words:
- laryngopharyngeal reflux /
- reflux symptom index /
- reflux finging scire /
- age
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表 1 3组患者RSI和RFS评分的比较
分，x±s 组别 例数 RSI RFS A组 86 19.81±3.24 9.11±2.54 B组 107 20.14±4.75 8.75±2.26 C组 65 15.27±3.17 8.92±1.74 F 3.54 1.85 P 0.01 0.46 
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表 2 C组RSI评分不同截断值对应敏感度和特异度
截断值 敏感度 特异度 截断值 敏感度 特异度 6.00 1.000 0.000 14.50 0.528 0.875 7.50 1.000 0.125 15.50 0.358 0.875 8.50 1.000 0.250 16.50 0.226 0.875 9.50 1.000 0.500 17.50 0.151 1.000 10.50 0.981 0.625 18.50 0.075 1.000 11.50 0.962 0.750 21.50 0.019 1.000 12.50 0.849 0.750 25.00 0.000 1.000 13.50 0.698 0.875
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