Correlation of pH probe-measured laryngopharyngeal reflux with symptoms and signs of reflux laryngitis
Correlation of pH probe-measured laryngopharyngeal reflux with symptoms and signs of reflux laryngitis
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DOI：
10.1097/00005537-200212000-00013
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发表时间：
2002-12-01
期刊：
影响因子：
2.6
通讯作者：
Levine, PA
中科院分区：
文献类型：
--
作者：
Noordzij, JP;Khidr, A;Levine, PA
目标/假设。胃酸反流引起的喉炎是一种流行的耳鼻喉科疾病，但尚未完全了解。需要进一步描述症状和体征与反流严重程度之间的关系。研究设计：前瞻性临床试验。研究方法：招募了42名有一种或多种反流性喉炎症状的连续非吸烟患者，完成症状问卷、视频频闪喉镜检查和24小时双传感器pH探针检测。29例患者咽喉反流发作超过4次，其余13例作为对照组。症状评分通过将严重程度乘以以下频率产生：声音嘶哑、咽喉疼痛、“喉咙肿块”感、清咽、咳嗽、痰多、吞咽困难、吞咽痛和胃灼热。喉部内视镜检查的症状包括声带和杓状软骨的红斑和水肿，以及杓状软骨间的不规则。结果：症状评分差异显著，清咽程度高于其他症状。除胃灼热外，无一症状与反流（咽喉和食管）严重程度相关。咽喉反流更严重的患者被发现有更严重的食管反流。内窥镜喉部体征平均评定为轻度，与咽喉反流严重程度无关。咽喉反流发作次数（每24 h）范围为0 - 40次（平均次数，10.6次）。结论.清咽是目前这组被证实患有反流性喉炎的患者中最强烈的症状。双传感器pH探头检测不能预测患者反流性喉炎症状或体征的严重程度。只有烧心症状与咽喉和食管反流有关。
Objectives/Hypothesis. Laryngitis secondary to gastric acid reflux is a prevalent, yet incompletely understood, otolaryngological disorder. Further characterization of the relationship between symptoms and signs and reflux severity is needed. Study Design: Prospective clinical trial. Methods: Forty-two consecutive, nonsmoking patients with one or more reflux laryngitis symptoms were recruited to complete a symptom questionnaire, videostrobolaryngoscopy, and 24-hour, dual-sensor pH probe testing. Twenty-nine patients had more than four episodes of laryngopharyngeal reflux, and the remaining 13 served as control subjects. Symptom scores were produced by multiplying the severity by the frequency for the following: hoarseness, throat pain, "lump-in-throat" sensation, throat clearing, cough, excessive phlegm, dysphagia, odynophagia, and heartburn. Endoscopic laryngeal signs included erythema and edema of the vocal folds and arytenoids, and interary-tenoid irregularity. Results: Symptom scores varied significantly, with throat clearing being greater than the rest. None of the symptoms, except heartburn, correlated with reflux (laryngopharyngeal and esophageal) severity. Patients with worse laryngopharyngeal reflux were found to have worse esophageal reflux. Endoscopic laryngeal signs were rated as mild, on average, and did not correlate with laryngopharyngeal reflux severity. The number of laryngopharyngeal reflux episodes (per 24 h) ranged from 0 to 40 (mean number, 10.6 episodes). Conclusions. Throat clearing was the most intense symptom in the present group of patients with proven reflux laryngitis. Dual-sensor pH probe testing could not predict the severity of patient's reflux laryngitis symptoms or signs. Only the heartburn symptom correlated with laryngopharyngeal and esophageal reflux.