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首页> 外文期刊>Journal of pediatric gastroenterology and nutrition >Value of the Likert dyspepsia scale in differentiation of functional and organic dyspepsia in children.
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Value of the Likert dyspepsia scale in differentiation of functional and organic dyspepsia in children.

机译：李克特消化不良量表在区分儿童功能性消化不良和器质性消化不良中的价值。

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AIM: Dyspeptic symptoms may not allow clinicians to differentiate organic and functional gastrointestinal disorders. According to our dyspeptic patients' answers to dyspepsia questionnaire, we aimed to define the symptom scores directing organic dyspepsia (OD) before upper gastrointestinal endoscopy. PATIENTS AND METHODS: One hundred sixty-one patients (ages 10-17 years, mean 13.5 +/- 2.3 years, male/female: 2/3) with chronic upper gastrointestinal system symptoms lasting for at least 3 months were enrolled. Patients with predominated reflux symptoms were excluded by 24-hour pH monitoring. Before upper gastrointestinal endoscopy, severity and incidence of 8 gastrointestinal symptoms (epigastric pain, upper abdominal discomfort, retrosternal pyrosis, bitter or sour taste in mouth, halitosis, belching, nausea, and early satiety) were measured by 5-point Likert scale. Total score indicated severity score multiplied by incidence score. Antral biopsy samples were obtained. OD is defined as peptic ulcer, erosive esophagitis, erosive or nodular gastritis, and erosive duodenitis in endoscopy and/or moderate to severe antral gastritis in histology. Functional dyspepsia (FD) is defined as normal findings/mucosal hyperemia in endoscopy and/or mild antral gastritis in antral histology. We evaluated the relation among severity and incidence scores of each dyspeptic symptom in patients with OD or FD. Age, sex, body mass index, drug history, nutritional habits, the quality of life related to dyspepsia were also investigated in patients with OD and FD. RESULTS: According to patients' histological and endoscopic findings, 100 (62%) patients were in the OD group and 61 (38%) patients were in the FD group. Of the dyspeptic complaints, the severity, incidence, and total scores of epigastric pain were significantly correlated with dyspepsia type (respectively, P = 0.042, P = 0.028, and P = 0.005). Of 93 patients who had an epigastric pain severity of 4 and 5 (namely, moderate to severe pain), 65 (70%) patients were in the OD group and 28 (30%) patients were in the FD group. Of 68 patients who had an epigastric pain severity of 0 to 3 (no epigastric pain or mild pain), 33 (48.5%) were in the OD group and 35 (51.5%) were in the FD group, and the difference was statistically significant (P = 0.042). After analyzing the total scores of 8 dyspeptic symptoms, one by one or in different combinations, we could not find a threshold (cutoff) score value that was able to indicate OD definitely. Age, sex, body mass index, and nutritional habits were not significantly different between patients with OD or FD. Nocturnal abdominal pain, pain before meals, and resolution of symptoms after meals or ingestion of antacid drugs were not significantly related to OD. Nocturnal abdominal pain was observed to be higher in the group with moderate to severe gastric inflammation. CONCLUSIONS: In the present study, the severity, incidence, and total scores of epigastric pain were significantly related to OD; however, a cutoff value of dyspepsia symptom score for differentiation of OD and FD could not determined. In our study, Likert dyspepsia scale was not beneficial in differentiation of the OD/FD groups. We suggest that the Likert dyspepsia scale should be redesigned for children or the same scale should be applied in a larger cohort of dyspeptic children.
机译：目的：消化不良症状可能不允许临床医生区分器质性和功能性胃肠道疾病。根据消化不良患者对消化不良问卷的回答，我们的目的是在上消化道内窥镜检查之前定义指导器官性消化不良（OD）的症状评分。患者与方法：入选了161例持续至少3个月的慢性上消化道症状的患者（年龄10-17岁，平均13.5 +/- 2.3岁，男性/女性：2/3）。 24小时pH监测排除了以反流症状为主的患者。在上消化道内窥镜检查之前，通过五点李克特量表测量了8种胃肠道症状的严重程度和发生率（胃痛，上腹部不适，胸骨后烧热，口苦或酸味，口臭，气，恶心和早饱）。总分表示严重性得分乘以发生率得分。获得肛门活检样品。 OD在内窥镜检查中定义为消化性溃疡，糜烂性食管炎，糜烂性或结节性胃炎和糜烂性十二指肠炎和/或组织学上为中度至重度胃窦炎。功能性消化不良（FD）定义为内窥镜检查中的正常发现/粘膜充血和/或肛门组织学中的轻度胃窦性胃炎。我们评估了OD或FD患者的每种消化不良症状的严重程度与发生分数之间的关系。在OD和FD患者中也调查了年龄，性别，体重指数，药物史，营养习惯，与消化不良有关的生活质量。结果：根据患者的组织学和内窥镜检查结果，OD组为100名（62％），FD组为61名（38％）。在消化不良的抱怨中，上腹痛的严重程度，发生率和总分与消化不良类型显着相关（分别为P = 0.042，P = 0.028和P = 0.005）。在上腹痛严重程度为4和5（即中度至重度疼痛）的93名患者中，OD组为65名（70％）患者，FD组为28名（30％）患者。腹痛严重程度为0至3（无腹痛或轻度疼痛）的68例患者中，OD组33例（48.5％），FD组35例（51.5％），差异有统计学意义（P ＝ 0.042）。在对8种消化不良症状的总评分进行逐一分析或以不同组合分析后，我们找不到能够明确表示OD的阈值（截止）评分值。 OD或FD患者之间的年龄，性别，体重指数和营养习惯无显着差异。夜间腹痛，饭前疼痛，饭后症状缓解或摄入抗酸药与OD无关。在中度至重度胃部炎症的人群中，夜间腹部疼痛较高。结论：在本研究中，上腹痛的严重程度，发生率和总分与OD显着相关。然而，消化不良症状评分的临界值无法确定OD和FD。在我们的研究中，李克特消化不良量表对OD / FD组的分化无益。我们建议应该为儿童重新设计李克特消化不良量表，或者对更多的消化不良儿童采用相同的量表。

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