Correlation analysis between Ryan index and reflux symptom index and reflux finding score, in the diagnosis of
WANG Gang, WU Wei, WANG Lei, LIU Hongdan, XU Xiaohang, XU Bingxin, DING Ruiying, ZHOU Ying, HAN Haolun, GONG Jing,LI Baowei, SUN Zhezhe
J Otolaryngol Ophthalmol Shandong Univ
2018, 32 ( 4):
Objective To explore the correlation between Ryan index and reflux symptom index(RSI)and reflux finding score(RFS), in the diagnosis of laryngopharyngeal reflux diseases. Methods In a retrospective study, the clinical data of 230 patients presenting at the hospital with suffering from laryngopharyngeal discomfort for more than a month, in our hospital from February 2016 to November 2016, were analyzed. All patients were received underwent electronic laryngoscopy, assessment of RSI and RFS, and pharyngeal pH monitoring. Results There were 35 patients(15.2%)whose with positive Ryan index were scorepositive(15.2%). The positive rate of RSI, RFS, RSI or RFS, and RSI and RFS were positive in 46.5%,28.7%,60.9%,and 13.9% of the patients, respectively. The RFS score in the Ryan index positive group was higher than that in the Ryan index negative group, while the RSI score in the Ryan index positive group was not statistically different from that in the Ryan index negative group. The Ryan index positive rates in the RFS, RSI or RFS, and RSI and RFS positive groups were higher than that in the RFS, RSI or RFS, and RSI and RFS negative groups. The kappa values between the Ryan index group and RSI, RFS, RSI or RFS, and RSI and RFS groups were -0.06,0.394,0.116, and 0.172, respectively. When pH monitoring was regarded as the gold standard, the sensitivity of RSI, RFS, RSI or RFS, and RSI and RFS were 37.1%, 74.3%, 82.9%, and 28.6%, respectively; the specificity was were 51.8%, 79.5%, 43.1%, and 88.2%, respectively; the positive predictive values was were 12.1%, 39.4%, 20.7%, and 30.3%, respectively; and the negative predictive values was were 82.1%,94.5%,93.3%,and 87.3%, respectively. The correlation coefficients between RSI and upright and supine Ryan scores were -0.056 and -0.083, respectively; the correlation coefficients between RFS and upright and supine Ryan scores were 0.425 and 0.166, respectively. Conclusion Pharyngeal pH monitoring is an objective and non-invasive method which can reflect laryngopharyngeal reflux directly. There is a positive correlation between the RFS and the Ryan index, however, the consistency of correlation between RFS/RSI and Ryan index were is poor. Further studies research areis needed to get moredevelop an accurate scale and pH diagnostic index for the diagnosis of laryngopharyngeal reflux disease.
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