Objective:To compare the consistency of RSI and RFS, pepsin detection and 24 h Dx-pH monitoring in the diagnosis of laryngopharyngeal reflux （LPR） in children. Method:A retrospective analysis was made of 76 children with suspicious LPR. A total of 65 children with suspicious LPR were finally diagnosed. RSI and RFS scales, pepsin detection and Dx-pH monitoring were performed simultaneously. The diagnostic consistency of the three methods was tested, and the sensitivity and specificity were calculated. Result:The sensitivity of pepsin detection, 24 h Dx-pH monitoring, RSI and RFS in the diagnosis of LPR in 76 suspected LPR patients were 95.31%, 66.15% and 84.62%, and the specificity were 100%, 81.82% and 72.73%. The pepsin detection was well consistent with the scale（Kappa>0.75）, pepsin detection and 24 h Dx-pH monitoring were in medium consistency（Kappa=0.467）, and 24 h Dx-pH monitoring and scale were in medium consistency（Kappa=0.446）. Conclusion:Pepsin detection can be used as a reliable index for the diagnosis of LPR in children. It is objective, economical, non-invasive, comfortable and easy to spread.
目的：探讨RSI和RFS量表评分、胃蛋白酶检测、pH监测在诊断儿童咽喉反流（LPR）的一致性、灵敏度及特异度。 方法：门诊诊断可疑LPR的患儿76例，最后确诊为LPR的患儿65例，对其同时进行RSI和RFS量表评分、胃蛋白酶检测及Dx-pH监测，检验3种方法的诊断一致性，并计算其灵敏度和特异度。 结果：76例可疑LPR患者中胃蛋白酶检测、24 h Dx-pH监测、RSI和RFS量表诊断LPR灵敏度分别为95.31%、66.15%和84.62%，特异度分别为100%、81.82%和72.73%。胃蛋白酶检测与RSI和RFS量表诊断结果一致性良好（Kappa>0.75），胃蛋白酶检测与24 h Dx-pH监测诊断结果一致性一般（Kappa=0.467），24 h Dx-pH监测与RSI和RFS量表诊断结果一致性一般（Kappa=0.446）。 结论：胃蛋白酶检测客观、经济无创、患儿无不适感，可作为诊断儿童LPR的可靠指标，易于临床推广。.
Keywords: laryngeal reflux; pH monitoring; pepsin; reflux finding score; reflux symptom index.
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