Acidic Pharyngeal Reflux Does Not Correlate with Symptoms and Laryngeal Injury Attributed to Laryngopharyngeal Reflux.
Acidic Pharyngeal Reflux Does Not Correlate with Symptoms and Laryngeal Injury Attributed to Laryngopharyngeal Reflux.
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酸性咽部反流与症状和喉损伤无关。
DOI：
10.1007/s10620-018-5372-1
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发表时间：
2019-05
影响因子：
3.1
通讯作者：
Kollarik, Marian
中科院分区：
文献类型：
--
作者：
Duricek, Martin;Banovcin, Peter;Halickova, Tatiana;Hyrdel, Rudolf;Kollarik, Marian
当症状归因于酸性胃食管反流（格尔）渗透到喉部时，怀疑咽喉反流（LPR）。然而，LPR强度与症状和喉损伤之间的关系尚未阐明。有几个因素混淆了LPR的研究，即在咽部监测pH值（咽返流），但诱导喉损伤所需的咽部酸度（pH值）未知，咽酸的格尔来源并不总是确定，最近使用质子泵抑制剂（PPI）的治疗混淆了分析。我们旨在限制这些混杂因素，以分析LPR与症状和喉损伤之间的关系。我们使用双重咽部和远端食管24小时pH/阻抗监测来确定咽部反流的格尔来源，我们使用无偏方法进行分析，通过评估30天以上无PPI的疑似LPR患者的整个酸度范围（pH <6，pH <5.5，pH <5.0，pH <4.5和pH <4.0）。咽部反流（中位数[IQR]）分别为14 [8 - 20.5]和4 [1.5 - 6.5]次咽部反流发作，pH <6.0和pH <5.5。pH <5.0的咽反流少见。综合分析未发现症状（反流症状指数）或喉损伤（反流发现评分）与任何pH水平下咽反流发作次数或咽酸暴露持续时间之间存在任何相关性。无偏的综合方法没有显示酸性咽反流与LPR引起的症状或喉损伤之间的任何关系。由于混杂因素，其他人报告的咽部监测的临床有效性有限。
Laryngopharyngeal reflux (LPR) is suspected when the symptoms are attributed to the penetration of acidic gastroesophageal reflux (GER) into the larynx. However, the relationships between the intensity of LPR and symptoms and laryngeal injury have not been elucidated. Several factors confound the study of LPR, namely pH is monitored in the pharynx (pharyngeal reflux) but the pharyngeal acidity (pH) required to induce laryngeal injury is unknown, the GER origin of pharyngeal acid is not always established, and a recent treatment with proton pump inhibitors (PPI) confounds the analysis. We aimed to limit these confounding factors to analyze the relationship between LPR and symptoms and laryngeal injury. We used dual pharyngeal and distal esophageal 24-h pH/impedance monitoring to establish GER origin of pharyngeal reflux, we used an unbiased approach to analysis by evaluating a whole range of acidity (pH < 6, pH < 5.5, pH < 5.0, pH < 4.5 and pH < 4.0) in patients with suspected LPR without PPI for > 30 days. Pharyngeal reflux was (median[IQR]) 14[8–20.5] and 4[1.5–6.5] pharyngeal reflux episodes with pH < 6.0 and pH < 5.5, respectively. Pharyngeal reflux with pH < 5.0 was rare. Comprehensive analysis did not reveal any correlation between symptoms (reflux symptom index) or laryngeal injury (reflux finding score) and the number of pharyngeal reflux episodes or duration of pharyngeal acid exposure at any pH level. Unbiased comprehensive approach did not reveal any relationship between acidic pharyngeal reflux and the symptoms or laryngeal injury attributed to LPR. Limited clinical usefulness of pharyngeal monitoring reported by others is unlikely due to confounding factors.
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影响因子：
5.5
作者：
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