喉部痰液胃蛋白酶浓度检测对喉咽反流诊断及疗效判定的价值

A study of the pepsin in the sputum for diagnosis and treatment evaluation of laryngopharyngeal reflux

目的:探讨喉部痰液胃蛋白酶检测对喉咽反流(LPR)诊断及其疗效判定的价值。方法:对2010-06-2010-07期间以咽干、咽喉部异物感、频繁清嗓、慢性咳嗽、发声易倦等症状就诊的36例患者进行3个月质子泵抑制剂诊断性治疗。治疗前后评估反流症状指数(RSI)、反流检查计分(RFS)及喉部痰液胃蛋白酶浓度。诊断性治疗有效者计入LPR组(15例),其余计入慢性咽炎组(21例),分析2组指标的差异和痰液胃蛋白酶检测的诊断价值。结果:所有患者RSI和RFS量表得分以及喉部痰液胃蛋白酶浓度在治疗后均有显著下降(均P<0.01)。LPR组RSI量表评分和胃蛋白酶浓度治疗前后的变化明显大于慢性咽炎组(均P<0.01);2组间RFS量表评分治疗前后的变化比较差异无统计学意义(P>0.05)。结论:喉部痰液胃蛋白酶浓度检测可以作为一项客观、有效的指标用于LPR的诊断和疗效判定。

Objective：To study the value of the pepsin in the sputum for diagnosing and evaluating the effectiveness of treatment of laryngopharyngeal reflux.Method：Thirty-six patients with the symptoms of dry pharynx,globus pharyngeus,excessive throat clearing,chronic cough and so on were divided into laryngopharyngeal reflux group and chronic laryngitis group by the results of therapeutic trial taking proton pump inhibitors for 3 months.The estimation of the reflux symptom index（RSI）,the reflux finding score（RFS） and the detection of pepsin in the sputum were done before and after the treatment.The difference between two groups and the value of the pepsin were analyzed.Result：There were significant decreasing in RSI,RFS and pepsin level（P0.01）after the treatment in all patients.There were statistical differences between the laryngopharyngeal reflux group and the chronic laryngitis group in the changes of RSI and pepsin level（P0.01）.Conclusion：Pepsin level in the sputum might be used as a objective,effective method for diagnosing and evaluating the effectiveness in laryngopharyngeal reflux.