不同类型咽喉反流性疾病患者临床特征的比较  

Comparison of clinical characteristics of patients with different types of laryngopharyngeal reflux disease

作　　者：李进让 王嘉森 吴慕坤 赵晶[1] 郭红光 Li Jinrang;Wang Jiasen;Wu Mukun;Zhao Jing;Guo Hongguang(Department of Otorhinolaryngology Head and Neck Surgery,the Sixth Medical center of Chinese People′s Liberation Army General Hospital,College of Otolaryngology Head and Neck Surgery,Chinese People′s Liberation Army General Hospital,National Clinical Research Center for Otolaryngologic Diseases,Beijing 100048,China)

机构地区：[1]解放军总医院第六医学中心耳鼻咽喉头颈外科,解放军总医院耳鼻咽喉头颈外科医学部,国家耳鼻咽喉疾病临床医学研究中心,北京100048

出　　处：《中华耳鼻咽喉头颈外科杂志》2021年第1期55-61,共7页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

摘　　要：目的比较不同类型咽喉反流性疾病患者的临床特征,以进一步明确非酸反流在咽喉反流性疾病中的作用。方法回顾性分析2015年1月至2020年1月就诊于解放军总医院第六医学中心可疑存在咽喉反流的349例住院或门诊患者的病例资料,其中男性303例,女性46例;年龄25~81岁,平均年龄56.03岁。所有患者均行24 h食管多通道腔内阻抗-pH(multichannel intraluminal impedance-pH, MII-pH)监测,监测前行喉镜检查,并记录患者的反流症状指数(reflux symptom index,RSI)评分和反流体征评分(reflux findings score,RFS),统计咽喉部酸反流和非酸反流事件次数,每一患者按酸反流事件与所有反流事件之比大于50%定义为酸反流为主类型,如果非酸反流事件占比大于50%则定义为非酸反流为主类型。比较不同反流类型患者的临床特征。应用SPSS 19.0软件进行统计学分析,对多个独立样本进行组间比较,定量资料采用多因素方差分析、计数资料采用组间χ2检验,P<0.05为差异有统计学意义。结果 349例患者行24 h MII-pH检查,结果显示无反流事件组90例,酸反流为主类型组51例,非酸反流为主类型组198例,酸反流和非酸反流事件相等者10例。统计发现无反流事件组的RSI [(10.72±4.40)分]、RFS [(7.70±2.73)分]和反流事件平均次数(0次)均低于酸反流为主类型组[RSI为(13.16±6.62)分,RFS为(10.08±3.03)分,反流事件平均次数为(5.33±3.15)次,P值均<0.05]和非酸反流为主类型组[RSI为(13.25±5.54)分,RFS为(8.81±2.54)分,反流事件平均次数为(7.93±5.26)次,P值均<0.05]。非酸反流为主类型组和酸反流为主类型组间的RSI差异无统计学意义(P>0.05),但非酸反流为主类型组的RFS低于酸反流为主类型组(P<0.05)。非酸反流为主类型组的反流事件平均次数高于酸反流为主类型组(P<0.05)。结论咽喉反流中存在酸反流和非酸反流。非酸反流为主类型较酸反流为主类型的RFS低,RSI得分无�Objective To compare the clinical characteristics of patients with different type of laryngopharyngeal reflux disease in order to study the effect of non-acid reflux on laryngopharyngeal reflux disease.Methods From January 2015 to January 2020,349 inpatients or outpatients suspected of having laryngopharyngeal reflux underwent 24-hour multichannel intraluminal impedance pH monitoring(MII-pH).There were 303 male and 46 female patients,with an average age of 56.03 years old ranged from 25 to 81 years old.The reflux symptom index(RSI)and reflux findings score(RFS)were recorded before MII-pH monitoring.The number of acid reflux events and non-acid reflux events in hypopharynx were counted.It was defined mainly acid reflux type when the ratio of acid reflux to all reflux events was greater than 50%,mainly non-acid reflux type when the ratio of non-acid reflux to all reflux events was greater than 50%.The clinical characteristics of patients with different type of reflux were compared.SPSS 19.0 software was used for statistical analysis,and multiple independent samples were compared between groups.The quantitative data were analyzed by multivariate analysis of variance,and the counting data were analyzed by chi-square test,the difference was statistically significant when P<0.05.Results The 24-hour MII-pH showed that there were 90 patients with no reflux events,51 patients with mainly acid reflux type,198 patients with mainly non-acid reflux type and 10 patients with equal acid reflux events and non-acid reflux events.Statistics showed that the RSI(10.72±4.40),RFS(7.70±2.73)and the average number of reflux events(0)in the group without reflux events were significantly lower than those in patients with mainly acid reflux type(RSI 13.16±6.62,RFS 10.08±3.03,average number of reflux events 5.33±3.15,P<0.05)and mainly non-acid reflux type(RSI 13.25±5.54,RFS 8.81±2.54,average number of reflux events 7.93±5.26,P<0.05).There was no significant difference in RSI between the mainly non-acid reflux type group and the main

关 键 词：疾病特征 反流 食管PH监测 评分 

分 类 号：R766[医药卫生—耳鼻咽喉科]