莱昂评分,一种新的GERD评分系统,显著预测了慢性咳的GERD患者对PPI的反应
Lorenzo Marchetti1, C Prakash Gyawali2, Edoardo Vincenzo Savarino3
1Department of Digestive Diseases, Campus Bio Medico University of Rome, Roma, Italy.
Neurogastroenterology and motility
|December 4, 2025
概括
里昂得分有效地预测了与GERD相关的慢性咳中的质子抑制剂 (PPI) 反应. 将其与阻抗监测相结合,进一步提高了这种常见疾病的诊断准确性.
科学领域:
- 胃肠病学和肝病学 胃肠学和肝病学
- 肺部病理学 肺部病理学
- 诊断医学 诊断医学 诊断医学
背景情况:
- 慢性咳是胃食道逆流症 (GERD) 的常见,难以治疗的症状.
- 目前用于与GERD相关的咳的诊断工具存在局限性,许多患者对标准质子抑制剂 (PPI) 治疗没有反应.
- 里昂得分是GERD的综合指标,尚未被评估用于预测慢性咳中PPI反应.
研究的目的:
- 评估里昂得分能够预测患有疑似与GERD相关的慢性咳患者的症状改善的能力.
- 确定里昂得分是否可以识别可能受益于高剂量PPI治疗的患者.
主要方法:
- 对232名患有慢性咳的成年患者的回顾性分析.
- 患者接受了上部内镜检查,高分辨率测量和24小时阻抗-pH监测.
- 质子抑制剂 (PPI) 应答被定义为在双剂量PPI治疗后≥8周的咳严重程度减少≥50%.
主要成果:
- 在232名患者中,40.5%对PPI治疗有反应.
- 受访者表现出明显更高的莱昂分数 (中位数为7.5对2.5,p < 0.0001).
- 里昂得分显示出强大的预测性能 (AUC 0.769),与多通道内阻抗 (MNBI < 1500 Ω,AUC 0.798) 相比,并且优于酸暴露时间 (AET,AUC 0.718).
结论:
- 里昂评分是识别可能对PPI治疗有反应的与GERD相关的慢性咳的宝贵工具.
- 将里昂分数和阻抗监测 (特别是低MNBI) 纳入诊断工作可以改善对PPI治疗成功的预测.
- 这种方法支持更好的患者分层和耐火性GERD相关慢性咳的管理.
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