- 期刊
Predicting Laryngopharyngeal Reflux in Patients with Globus
喉部塊狀異物感是否為咽喉逆流的預測因子
摘要
背景和目的：咽喉逆流（laryngopharyngeal reflux，LPR）被認為是導致喉部有塊狀異物感最常見的原因。在文獻記載中，有喉部塊狀異物感的患者有可能是咽喉逆流的患者，也有可能不是。本篇研究的目的就是評估臨床上喉部有塊狀異物感的表徵，和是否有咽喉逆流的交互關係。病患和方法：一個37人具有globus症狀的群組研究，對象是疑似有食道外逆流症狀者，所有的患者皆接受了同一名耳鼻喉科醫師的檢查，並且以逆流表徵分數（reflux finding score，RFS）加總所有的臨床症狀。而所有的病患完成了逆流症狀指數（reflux symptom index，RSI）評估者，都接受胃鏡及24小時攜帶式食道酸鹼值測定（24-hour pH monitoring）。依據24小時攜帶式食道酸鹼值測定將病患分成咽喉逆流陽性（n=15）和咽喉逆流陰性（n=22）兩個族群。患者的基本資料，內視鏡影像，和逆流症狀指數將被分別的比較。結果：依據24小時攜帶式食道酸鹼值監測結果顯示，本研究有15位（40.5%）患者被診斷為咽喉逆流。本研究中無LPR的組群，其人口資料和臨床數據包含年齡、性別、身體質量指數、reflux symptoms皆顯示無統計上的顯著意義。相對於咽喉逆流陰性族群，咽喉逆流陽性族群有較短期症狀的患者（症狀持續少於一年）（60% vs. 32%），但是這個結果並無統計學上的差異（P=0.09）。胃鏡下食道炎的發生率，在兩個族群中並沒有顯著的差別。逆流症狀指數的總分數與陽性率在兩個組別中也並無明顯差別。結論：病患的基本資料，臨床表徵以及內視鏡下的發現，或逆流症狀指數都無法分辨喉部有塊狀異物感病患是否患有酸鹼值定義的咽喉逆流。
並列摘要
Background and Aim: Laryngopharyngeal reflux (LPR) is one of the common etiologies of globus pharyngeus. Patients with globus symptom, on the other hand, can be either LPR positive or negative. The aim of the study was to assess demographic, clinical and endoscopic predictors in these two groups of patients. Patients and Methods: A cohort of 37 patients with globus was enrolled in the study. Their globus symptom was initially thought to be a result of extra-esophageal reflux. Reflux Finding Score (RFS) for each patient was summed up by a single otolaryngologist blinded from the results of other studies. All patients completed Reflux Symptom Index (RSI) questionnaire, received esophagogastroduodenoscopy and 24-hour ambulatory pH monitoring. Patients were classified into LPR-positive (n=15) and LPR-negative (n=22) groups based on the result of 24-hour pH monitoring. Their demographics, clinical presentation, endoscopic findings, and RSI were analyzed. Results: Fifteen patients (41%) were diagnosed as having LPR based on the result of 24-hour pH monitoring. Their demographic and clinical data, including age, sex, body mass index and reflux symptoms, showed no statistical difference from those having no LPR. Shorter duration of globus symptom (less than one year) was more frequently observed in LPR-positive than LPR-negative group (60% vs. 32%), although this did not reach statistical significance (P=0.09). Prevalence of endoscopically-documented esophagitis in this cohort was 20% in LPR-positive group and 18.2% in LPR-negative group (P=1). Total scores and positive rate of RSI and RFS between the two groups were not statistically different. Conclusion: Patient demographics, clinical presentation, endoscopic findings and RSI are not useful in predicting pH-documented LPR in patients with globus.