The diagnostic utility of the frequency scale for the symptoms of gastroesophageal reflux disease questionnaire (FSSG) for patients with subacute/chronic cough
The diagnostic utility of the frequency scale for the symptoms of gastroesophageal reflux disease questionnaire (FSSG) for patients with subacute/chronic cough
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DOI：
10.1080/02770903.2020.1805750
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发表时间：
2020-08
影响因子：
1.9
通讯作者：
Ryota Kurokawa;Y. Kanemitsu;Kensuke Fukumitsu;Norihisa Takeda;J. Yap;Motohiko Suzuki;Y. Mori;S. Fukuda;T. Uemura;T. Tajiri;H. Ohkubo;K. Maeno;Y. Ito;T. Oguri;M. Takemura;A. Niimi
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作者：
Ryota Kurokawa;Y. Kanemitsu;Kensuke Fukumitsu;Norihisa Takeda;J. Yap;Motohiko Suzuki;Y. Mori;S. Fukuda;T. Uemura;T. Tajiri;H. Ohkubo;K. Maeno;Y. Ito;T. Oguri;M. Takemura;A. Niimi
摘要背景胃食管反流病（GERD）症状频率量表（FSSG）问卷最初包括酸反流和动力障碍症状领域，是一种评价胃食管反流病（GERD）症状的简明问卷。目的评价胃食管反流病（GERD）主观问卷对GERD相关性咳嗽的诊断价值。方法收集2012年4月至2018年3月256例亚急/慢性咳嗽患者，采用FSSG问卷和血嗜酸性粒细胞计数进行分析。通过存在典型的反流症状（包括胃灼热和/或典型的咳嗽触发因素（例如发声、起立、说谎、进食和摄入某些食物））推断GERD相关咳嗽。通过对GERD特定治疗的反应证实了诊断。进行受试者工作特征曲线分析，以确定诊断的临界值。结果110例（43%）患者诊断为GERD相关性咳嗽。FSSG问卷与诊断GERD相关咳嗽相关，曲线下面积（AUC）为0.70（p < 0.0001，临界值7分，灵敏度75%，特异性62%）。当仅限于血嗜酸性粒细胞≤150/μL或痰嗜酸性粒细胞≤ 3%的患者时，诊断的敏感性和特异性分别增加（敏感性和特异性;血嗜酸性粒细胞为79%和65%，痰嗜酸性粒细胞为82%和68%。p < 0.0001，AUC均为0.74）。结论胃食管反流病主观问卷（FSSG）有助于诊断胃食管反流病相关性咳嗽，尤其是血或痰嗜酸性粒细胞计数低的患者。
Abstract Background The frequency scale for the symptoms of GERD (FSSG) questionnaire, which originally consists of acid-reflux and dysmotility symptom domains, is a succinct questionnaire to evaluate gastroesophageal reflux disease (GERD) symptoms. Objectives To evaluate the utility of subjective questionnaire of GERD for the diagnosis of GERD-related cough by using FSSG questionnaire. Methods We recruited 256 patients with subacute/chronic cough between April 2012 and March 2018, who were analyzed using FSSG questionnaire and blood eosinophil counts. GERD-related cough was inferred through the presence of classic reflux symptoms including heartburn and/or typical coughing trigger (e.g. phonation, rising, lying, eating, and intake of certain food). The diagnosis was confirmed by response to specific treatments for GERD. Receiver operating characteristic curve analysis was performed to determine the cutoff score for the diagnosis. Results One-hundred ten patients (43%) were diagnosed as having GERD-related cough. FSSG questionnaire was relevant for diagnosing GERD-related cough, with the area under the curve (AUC) of 0.70 (p < 0.0001, cutoff score 7 points, sensitivity 75%, specificity 62%). When limited to patients with blood eosinophils of ≤150/μL or those with sputum eosinophils of ≤3%, sensitivity and specificity of the diagnosis was increased, respectively (sensitivity and specificity; 79% and 65% for blood eosinophils and 82% and 68% for sputum eosinophils. p < 0.0001, AUC 0.74 for both). Conclusions The subjective questionnaire of GERD (FSSG) would be helpful in diagnosing GERD-related cough, particularly in patients with low blood or sputum eosinophil counts.