摘要目的 探讨厦门大学附属第一医院耳鼻咽喉头颈外科咽喉反流性疾病( LPRD)医师诊断结果与反流症状指数(RSI)量表评估结果的一致性及其影响因素.方法 采用等比系统随机抽样法随机选取2017年7月至2018年6月厦门大学附属第一医院耳鼻咽喉头颈外科门诊收治的2 066例成年患者,男1 320例,女746例,年龄(39. 0 ± 11. 7)岁,年龄范围为18~84岁.患者在医护人员的指导下填写调查问卷,包括社会人口学特征,吸烟、饮酒情况,使用抑酸、胃动力药物治疗情况等,以RSI评分为依据,了解厦门大学附属第一医院耳鼻咽喉头颈外科门诊患者反流性咽喉炎的构成比,评估医师诊断结果与金标准的一致性及其影响因素.结果 以RSI量表评估结果为依据,咽喉反流性疾病的构成比为12. 20% (252/2 066);医师诊断结果的灵敏度为23. 02% ,特异度为98. 46% ,阳性预测值为67. 44% ,阴性预测值为90. 20% ,约登指数为21. 47% ,Kappa值为0. 30,一致性较低.与其他亚组比较,35~45岁年龄组、男性、吸烟、饮酒、使用抑酸、胃动力药物治疗患者RSI量表评估结果与医师诊断结果的一致性较高.结论 医师诊断的LPRD与RSI量表评估结果的一致性较低,有效利用RSI量表对咽喉反流性疾病进行诊断有助于提高对LPRD患者的早期治疗和干预.

abstractsObjective To investigate the diagnosis consistency of laryngopharyngeal reflux disease (LPRD) between doctors and the evaluation of reflux symptom index( RSI) scale,and explore its influen-cing factors among outpatients of otolaryngology,head and neck surgery department. Methods From July 2017 to June 2018,2 066 adult patients(1 320 males and 746 females),age(39. 0 ± 11. 7) years old,ran-ging from 18 to 84 years old,were randomly selected by isometric random sampling method. Patients under the guidance of medical staff to fill in questionnaires,including social demographic characteristics,smoking, drinking alcohol,using acid suppression,stomach,such as dynamic drug treatment based on RSI score,un-derstanding of patients with reflux sex composition of strep throat,assessment was diagnosed results consist-ent with the gold standard and its influencing factors. Results Based on the RSI scale,the composition ra-tio of laryngopharyngeal reflux disease was 12. 20% (252/2 066). The sensitivity,specificity,positive pre-dictive value,negative predictive value,youden index and Kappa value were 23. 02% ,98. 46% ,67. 44% , 90. 20% ,21. 47% and 0. 30,respectively,indicating a low consistency. Compared with other subgroups,the results of RSI scale in 35 to 45 years old group,male group,smoking group,drinking group,using acid-in-hibiting group and gastric dynamic group were consistent with the results of physicians′diagnosis. Conclu-sion The consistency between the evaluation results of LPRD diagnosed by physicians and the RSI scale is low,and the effective use of the RSI scale in the diagnosis of laryngopharyngeal reflux disease is helpful to improve the early treatment and intervention of LPRD patients.