诊断学理论与实践2025，Vol.24Issue(4)：359-364,6.DOI:10.16150/j.1671-2870.2025.04.001
胃食管反流病临床诊断中检查方法应用策略
Application strategies of examination methods in clinical diagnosis of gastroesophageal reflux disease
摘要
Abstract
Gastroesophageal reflux disease(GERD)is a common digestive system disease.Epidemiological studies show that the incidence of GERD ranges from 10%to 30%in Europe and the United States,while the incidence in China is relatively lower,at approximately 10%.In recent years,the incidence of GERD in China has shown an increasing trend.Dif-ferent diagnostic methods include pH monitoring and pH-impedance testing,endoscopy,high-resolution esophageal manometry,proton pump inhibitor(PPI)test,and salivary pepsin testing.Endoscopy enables direct observation of lesions but exhibits relatively low sensitivity.PPI tests are simple and practical but cannot provide a definitive diagnosis.Question-naires are highly subjective.Salivary pepsin testing can evaluate laryngopharyngeal reflux,but its accuracy is limited by enzyme degradation.The sensitivity and specificity of these diagnostic methods differ.Among them,questionnaires demon-strate good performance in GERD diagnosis,with a sensitivity of 77.50%and a specificity of 87.31%.Salivary pepsin tes-ting in GERD diagnosis shows a sensitivity of 73.0%and specificity of 88.3%.The PPI test is suitable for patients with typi-cal reflux symptoms,but the response rate significantly decreases in patients with atypical symptoms.Reflux and heartburn are not exclusive to GERD.These two symptoms may also occur in other conditions,such as achalasia,functional heart-burn,reflux hypersensitivity,and eosinophilic esophagitis,potentially leading to misdiagnosis in some cases.Meanwhile,GERD is a complex syndrome involving multiple pathogenic factors and pathophysiological mechanisms.When formulating treatment strategies,clinicians should adopt individualized and precision treatment tailored to the pathological and physio-logical mechanisms of patients with different clinical manifestations.In the future,with further research and the application of new technologies,individualized precision treatment will become the core of GERD management,aiming to improve patients'quality of life and reduce the recurrence rate.关键词
胃食管反流病/临床诊断/pH监测/内镜Key words
Gastroesophageal reflux disease/Clinical diagnosis/pH monitoring/Endoscopy分类
医药卫生引用本文复制引用
张玲,姚玮艳,邹多武..胃食管反流病临床诊断中检查方法应用策略[J].诊断学理论与实践,2025,24(4):359-364,6.基金项目
上海市卫生健康委员会卫生行业临床研究专项(20244Y0032) （20244Y0032）
申康课题(SHDC2020CR2029B) （SHDC2020CR2029B）
