Optimal timing of saliva collection to detect pepsin in patients with laryngopharyngeal reflux
Optimal timing of saliva collection to detect pepsin in patients with laryngopharyngeal reflux
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DOI：
10.1002/lary.26018
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发表时间：
2016-12-01
期刊：
影响因子：
2.6
通讯作者：
Eun, Young-Gyu
中科院分区：
文献类型：
--
作者：
Na, Se Young;Kwon, Oh Eun;Eun, Young-Gyu
目的/假设测定唾液胃蛋白酶水平与采集时间的关系。研究设计：前瞻性病例对照研究。方法选择57例有咽喉反流临床症状和体征的患者进行24小时管腔内阻抗-pH(24小时MII-pH)监测，并与12例无咽喉反流临床症状体征的对照组进行比较。所有受试者在醒来时、每次用餐后1小时(每天3次)以及出现咽喉部反流(LPR)症状时采集唾液样本。采用酶联免疫吸附试验检测唾液中胃蛋白酶水平。结果50例根据24小时MII-pH监测结果诊断为LPR的患者进入本研究。清醒时的平均胃蛋白酶水平为17.2 ng/m L，显著高于其他时间的测定结果(P<；0.005)。LPR患者胃蛋白酶水平明显高于对照组。两组患者的反流症状指数评分差异有统计学意义。结论在24小时MII-pH监测中，出现LPR症状且至少有一次近端食道反流的患者，在清醒时采集的唾液中总胃蛋白酶水平显著升高。此外，清醒时的平均胃蛋白酶水平高于其他任何时候。清醒时测定唾液中胃蛋白酶水平可能是诊断LPR的一种有用的方法.3b喉镜，126：2770-2773,2016
Objectives/HypothesisTo determine salivary pepsin levels as a function of collection time.Study DesignA prospective, case-control study.MethodsWe selected 57 patients with clinical symptoms and signs of laryngopharyngeal reflux who underwent 24-hour multichannel intraluminal impedance-pH (24h MII-pH) monitoring tests, and 12 control subjects without clinical symptoms and signs of laryngopharyngeal reflux. All subjects were instructed to collect saliva samples upon waking, 1 hour after each meal (3 times per day), and upon any occurrence of laryngopharyngeal reflux (LPR) symptoms. The pepsin levels in saliva were measured by using enzyme-linked immunosorbent assay. The Reflux Symptom Index survey was also administered.ResultsA total of 50 patients in whom LPR was diagnosed based on results of 24h MII-pH monitoring test were enrolled in the study. The average pepsin level upon waking was 17.2 ng/mL, which was significantly higher than that measured in samples collected at any other time (P < .005). Pepsin levels were higher in patients with LPR than those in controls. The Reflux Symptom Index scores were statistically different between these groups of subjects.ConclusionsThe levels of total pepsin in saliva collected upon waking were significantly higher in the group of patients presenting with LPR symptoms and who demonstrated at least one episode of proximal esophageal reflux during 24h MII-pH monitoring. Furthermore, the average pepsin level upon waking was higher than that measured at any other time. Measuring pepsin levels in the saliva upon waking may be a useful method in the diagnosis of LPR.Level of Evidence3b Laryngoscope, 126:2770-2773, 2016