咽喉反流与嗓音疾病的相关分析  

Correlation of Laryngopharyngeal Reflux and Voice Disorders

作　　者：严森[1] 徐文[1] 李赟[1] 郑莉[1] 张玉焕[1] 

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科耳鼻咽喉头颈外科学教育部重点实验室,北京100730

出　　处：《听力学及言语疾病杂志》2014年第1期34-38,共5页Journal of Audiology and Speech Pathology

基　　金：北京市卫生系统高层次卫生技术人才骨干基金(2009-3-33)

摘　　要：目的探讨咽喉反流(laryngopharyngeal reflux,LPR)与嗓音疾病的相关关系。方法对103例疑有LPR相关症状的成年患者行反流症状指数量表(reflux symptom index,RSI)、反流体征计分量表(reflux finding score,RFS)、24小时双探头食管pH值监测,其中伴有嗓音疾病患者89例,分别为声带接触性肉芽肿组18例,慢性喉炎组19例,声带息肉组15例,声带白斑组21例,声带任克水肿组16例,余14例无嗓音疾病(对照组)。结果 103例患者中诊断为LPR的阳性率为46.6%(48/103),89例嗓音疾病患者LPR阳性率为48.30%(43/89),其中声带任克水肿组LPR阳性率(75%,12/16)、声带白斑组LPR阳性率(71.4%,15/21)显著高于对照组(35.7%,5/14)(P=0.030,P=0.036)。慢性喉炎组、声带任克水肿组RSI得分(13.5±7.2、13.9±2.3分)显著高于对照组(9.1±2.9分)(P=0.019,P=0.020);声带任克水肿组RFS得分(12.6±2.9分)显著高于对照组(7.6±2.9分)(P=0.009)。声带白斑组立位酸反流次数、卧位酸反流次数、总酸反流次数、立位酸反流时间、总酸反流时间显著高于对照组(P=0.011,P=0.004,P=0.015,P=0.034,P=0.027);声带任克水肿组立位酸反流次数、总酸反流次数、立位酸暴露百分比、总酸暴露百分比、立位酸反流时间、总酸反流时间显著高于对照组(P=0.025,P=0.039,P=0.041,P=0.030,P=0.012,P=0.011)。结论声带白斑、声带任克水肿与LPR相关性较高,两种疾病患者的咽喉部24小时食管pH值监测表现为反流次数多、时间长。Objective To study the correlation between laryngopharyngeal reflux （LPR） and voice disorders. Methods One hundred and three patients with reflux - related symptoms were recruited. The patients were evalu-ated with reflux symptom index （RSI）, reflux finding score （RFS） evaluation and 24-hour dural-probe pH moni-toring. Eighty-nine cases with voice disorders were divided into 5 groups： vocal process granuloma （n=18） chron-ic pharyngolaryngitis （n=19）, vocal polyps （n=15）, vocal fold leukoplakia （n=21） and Reinke＇s edema （n=16）. The other 14 patients without voice disorders were the control subjects. Results According 24-hour dural-probe pH monitoring assessments, 48.3 % of the patients with voice disorders showed LPR positive. The positive rate in the vocal fold leukoplakia group （71.4%） and Reinke＇s edema group （75.0%） were significantly higher than the control group （35.7%）. RSI and RFS of the patients with Reinke＇s edema were both significantly higher than the control group（P=0. 020,P=0. 009）. RSI of the patients with chronic pharyngolaryngitis were significantly higher than the control group （P=0. 019）. The acid reflux episodes, acid reflux time which except in the supine position of the vocal fold leukoplakia group were significantly higher than the control group. The acid reflux episodes, acid ex-posure and acid reflux time which all except in the supine position of the Reinke＇s edema group were significantly higher than the control group. Conclusion The correlations between Reinke＇s edema, vocal fold leukoplakia and LPR were stronger. In these two groups, the acid reflux episodes were higher and acid reflux times were longer.

关 键 词：咽喉反流 嗓音疾病 24小时双探头食管pH值监测 反流症状指数量表 反流体征计分量表 

分 类 号：R767.92[医药卫生—耳鼻咽喉科]