How much pharyngeal exposure is "normal"? Normative data for laryngopharyngeal reflux events using hypopharyngeal multichannel intraluminal impedance (HMII).
How much pharyngeal exposure is "normal"? Normative data for laryngopharyngeal reflux events using hypopharyngeal multichannel intraluminal impedance (HMII).
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DOI：
10.1007/s11605-011-1741-1
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发表时间：
2012-01
影响因子：
3.2
通讯作者：
Jobe, Blair A.
中科院分区：
文献类型：
--
作者：
Hoppo, Toshitaka;Sanz, Alejandro F.;Nason, Katie S.;Carroll, Thomas L.;Rosen, Clark;Normolle, Daniel P.;Shaheen, Nicholas J.;Luketich, James D.;Jobe, Blair A.
关键词：
咽喉反流（LPR）可引起非典型症状、哮喘和肺纤维化。本研究的目的是建立正常的数据使用下咽多通道腔内阻抗（HMII）的LPR。无症状受试者在质子泵抑制剂（PPI）2周疗程前后接受内镜检查，随后使用专门的阻抗导管进行24小时HMII，阻抗导管配置为检测LPR。如果受试者有食管病理学或DeMeester评分阳性，则将其排除。一个队列的24例LPR患者谁有一个完全响应的治疗用于比较与规范数据。入组了40例受试者。34名受试者完成了一项测试，25名受试者完成了停药和服用PPI的两项HMII测试。关闭和使用PPI之间的反流事件总数无差异[分别为22（8-32）和24（10-28），p=0.89]。LPR关闭和PPI开启的第95次二进制数分别为0和1。所有治疗有效LPR患者的治疗前HMII LPR值均大于第95百分位数。LPR事件在无症状人群中罕见。在有LPR症状的患者中，无论DeMeester评分是否为阳性，一个或多个LPR事件均应视为异常。
Laryngopharyngeal reflux (LPR) can cause atypical symptoms, asthma, and pulmonary fibrosis. The aim of this study was to establish the normative data for LPR using hypopharyngeal multichannel intraluminal impedancepH (HMII). Asymptomatic subjects underwent endoscopy followed by 24-h HMII using a specialized impedance catheter configured to detect LPR before and after a 2-week course of proton pump inhibitors (PPI). Subjects were excluded if they had esophageal pathology or a positive DeMeester score. A cohort of 24 LPR patients who had a complete response to treatment was used for comparison with the normative data. Forty subjects were enrolled. Thirty-four subjects completed one, and 25 completed both HMII testing periods off and on PPI. There was no difference in the total number of reflux events between off and on PPI [22 (8–32) and 24 (10–28), respectively, p=0.89]. The 95th percentiles of LPR off and on PPI were 0 and 1, respectively. All patients with treatment responsive LPR had pre-treatment HMII values of LPR greater than the 95th percentile. LPR events are rare in an asymptomatic population. One or more LPR events should be considered abnormal in patients with LPR symptoms regardless of whether there is a positive DeMeester score.
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