胃食管反流对咽喉反流病患者的食管动力学影响

The effect of gastroesophageal reflux in esophageal dynamics of laryngopharyngeal reflux disease

目的应用高分辨率食管测压的方法,通过与正常人群的比较,探讨胃食管反流对咽喉反流病(laryngopharyngeal reflux disease,LPRD)患者的食管动力学影响。方法将初筛为LPRD的患者进行诊断性治疗,治疗前后均行高分辨率食管测压检测。按胃食管反流病(gastroesophageal reflux disease,GERD)问卷评分标准,分为单纯LPRD组和LPRD伴GERD组。无咽喉不适的健康人群设为对照组。结果确诊为LPRD的患者56例,单纯LPRD组24例,LPRD伴GERD组32例,正常对照组20例。LPRD患者的年龄、性别构成比、BMI指数等较对照组差异均无统计学意义(P>0.05),吸烟、饮酒及睡前3小时进食的患者构成比较对照组有统计学差异(P<0.05)。单纯LPRD食管动力参数较对照组均无统计学差异(P>0.05)。LPRD伴GERD组的UESP、LESP、DCI、DL较对照组均有统计学意义(P<0.05)。结论单纯咽喉反流病无明显食管动力异常,而胃食管反流病能导致咽喉反流病的食管动力障碍,一定程度上提示了单纯咽喉反流病与胃食管反流病存在不同的发病机制。

Objective To study the effect of gastroesophageal reflux in esophageal dynamics of laryngopharyngeal reflux disease （LPRD）, compared with the normal group, by means of high resolution esophageal manometry. Methods Early screening of patients with LPRD were achieved diagnostic treatment and performed with high resolution esophageal manometry before and after treatment. According to gastroesophageal reflux disease （GERD） questionnaire score standards, the patients were divided into pure LPRD group and LPRD with GERD group. Healthy people without throat discomfort were set as control group. Results The diagnosis of LPRD was 56 cases, of which the pure LPRD group was 24 cases, LPRD with GERD group was 32 cases. Normal control group was 20 cases. The differences of the LPRD patient＇s age, gender ratio and BMI index compared with the control group had no statistical significance （P〉0.05）, the constituent ratio between the patients who were smoking, drinking and eating in three hours before bed and the control group bad statistically significant （P〈0.05）. There was no statistical difference in Pure LPRD esophageal dynamic parameters （P〉0.05）. The UESP, LESP, DCI and DL in LPRD with GERD group had statistical significance than the control group （P〈0.05）. Conclusion Pure laryngopharyngeal reflux disease had no obvious abnormal esophageal dynamic, and gastroesophageal reflux disease can lead to the dynamic obstacles in the laryngopharyngeal reflux disease, which to some extent suggests the different pathogenesis between the pure LPRD and GERD.