胃超声造影对老年人十二指肠胃反流的诊断价值

Value of contrast-enhanced ultrasonography in the diagnosis of pathological duodenogastric reflux in the elderly

摘要:

目的 探讨胃超声造影在老年人病理性十二指肠胃反流（DGR）诊断中的应用价值。方法 选 取2017 年1 月—2017 年12 月湖南省人民医院32 例病理性十二指肠胃反流老年患者（DGR 组）和26 例同 期健康志愿者（对照组）行胃超声造影检查，动态观察两组幽门口的反流情况。比较两组幽门口内径、反流 次数及反流时间段，绘制受试者工作特征（ROC）曲线；计算特异性、敏感性及曲线下面积，根据约登指数 确定诊断截断点。结果 ①两组反流次数、幽门口内径及反流时间段比较，差异有统计学意义（P <0.05）； ② ROC 曲线分析表明，幽门口内径特异性为96.2%，敏感性为87.5%，ROC 曲线下面积为0.973 ；反流次数 特异性为96.2%，敏感性为90.6%，ROC 曲线下面积为0.979 ；反流时间段特异性为80.8%，敏感性为90.6%， ROC 曲线下面积为0.905 ；两组各指标比较，差异有统计学意义（P <0.05）。结论 胃超声造影可诊断 DGR，能为临床对老年人，特别是有心肺等功能障碍的老年患者诊断DGR 提供有效的诊断手段。

Abstract:

Objective To evaluate the value of contrast-enhanced ultrasound in the diagnosis of pathological duodenogastric reflux in the elderly. Methods A total of 32 elderly patients with duodenal gastric reflux disease (group DGR, 60 ～ 89 years old) and 26 healthy volunteers (control group, 60 ～ 89 years old) were examined by gastric ultrasound contrast examination. The reflux situation between the duodenum and the stomach in the two groups was observed dynamically, and the ROC curves of the pyloric diameter, reflux number and reflux time period were compared between the two groups. The area, sensitivity and specificity of the curve were calculated, and the diagnostic threshold was determined according to the Jordan index. Results ① There were statistically significant differences between the two groups in the pyloric diameter, the number of reflux and the reflux time period (P < 0.05). ② In the comparison between DGR group and control group, area under curve (AUC), sensitivity and specificity of pyloric diameter were 0.973, 87.5% and 96.2% respectively; those of reflux number were 0.979, 90.6% and 96.2%; those of reflux time period were 0.905, 90.6% and 80.8%. The difference of each index between the two groups was statistically significant (P < 0.05). Conclusions Contrast-enhanced gastric ultrasound can diagnoses DGR, which can provide an effective method for the diagnosis of gastroduodenal reflux in the elderly, especially the elderly with cardiopulmonary dysfunction.