Limited Clinical Utility of Lipid-Laden Macrophage Index of Induced Sputum in Predicting Gastroesophageal Reflux-Related Cough.
Limited Clinical Utility of Lipid-Laden Macrophage Index of Induced Sputum in Predicting Gastroesophageal Reflux-Related Cough.
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诱导痰载脂巨噬细胞指数在预测胃食管反流相关咳嗽方面的临床效用有限
DOI：
10.4168/aair.2021.13.5.799
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发表时间：
2021-09
期刊：
影响因子：
--
通讯作者：
Chen R
中科院分区：
文献类型：
--
作者：
Dong J;Huang J;Liu J;Tang Y;Sivapalan D;Lai K;Zhong N;Luo W;Chen R
胃食管反流病（GERD）是慢性咳嗽（CC）的常见原因。然而，基于24小时食管pH监测或对经验性抗反流试验的有利反应诊断与CC相关的GERD是侵入性的且耗时。载脂巨噬细胞（LLM）被认为是呼吸道中胃内容物微吸入的生物标志物。本研究采用痰液诱导技术收集LLM，观察LLM量与咳嗽严重程度、24 h食管pH监测参数及治疗反应的关系。对57例疑诊胃食管反流病的CC患者进行24小时食管pH监测和痰液诱导。34例患者在8周的经验性抗反流试验后进行随访，以记录治疗反应。载脂巨噬细胞指数（LLMI），LLM的半定量计数，与近端或远端电极的24小时食管pH监测值无显著相关性。LLMI或DeMeester评分以及咳嗽症状相关概率在应答者和非应答者之间无差异。有效率为50%，无效率为6%（P < 0.05）。我们的研究表明，LLMI在临床诊断与CC相关的GERD作为潜在病因或预测抗反流治疗反应方面的效用有限。抗反流治疗对于有反流症状的CC患者比没有反流症状的患者更有效。
Gastroesophageal reflux disease (GERD) is a common cause of chronic cough (CC). However, the diagnosis of GERD associated with CC based on 24-hour esophageal pH-monitoring or favorable response to empirical anti-reflux trials is invasive and time-consuming. Lipid-laden macrophages (LLMs) are supposed to be a biomarker for micro-aspiration of gastric content in the respiratory tract. This study was conducted to collect LLMs by the sputum induction technique and observe the relationship among the amount of LLMs, cough severity, parameters of 24-hour esophageal pH-monitoring and therapeutic response. The 24-hour esophageal pH-monitoring and sputum induction were performed on 57 patients with suspected GERD associated with CC. Thirty-four patients were followed up after empirical anti-reflux trials of 8 weeks to record the therapeutic response. Lipid-laden macrophage index (LLMI), a semiquantitative counting of LLMs, showed no significant correlation with the values of 24-hour esophageal pH monitoring at the proximal or remote electrode. No difference in LLMI or DeMeester score, as well as cough symptom association probability, were found between the responders and the non-responders. Reflux symptoms were more common in the responders (50%) compared to the non-responders (6%) (P < 0.05). Our study suggests that LLMI shows limited utility in clinically diagnosing GERD associated with CC as an underlying etiology or in predicting response to anti-reflux therapy. Anti-reflux therapy is more effective for CC patients with reflux symptoms than for those without.
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