Pribuisiene Rūta, Uloza Virgilijus, Jonaitis Laimas
Kauno medicinos universiteto Ausu, nosies, gerkles ligu klinika, Eiveniu 2, 3007 Kaunas.
Medicina (Kaunas). 2002;38(7):699-705.
The aim of the study was to evaluate and compare intensity and incidence of both, typical (heartburn, acid regurgitation) and atypical (hoarseness, throat clearing, globus pharyngeus) symptoms of laryngopharyngeal reflux disease among 72 patients and 123 healthy persons. Diagnosis of laryngopharyngeal reflux disease in 58 cases (80.6%) was confirmed by endoscopic and histological findings of esophagitis and in 14 cases (19.4%) by Omeprasol test. The intensity of the symptom was calculated by multiplication of the intensity and frequency of the symptom. According to the data obtained laryngopharyngeal reflux disease manifested more frequently with atypical symptoms. In the patients' group mean intensity of hoarseness was 5.29 +/- 0.74 points, mean index of hoarseness 7.06 +/- 1.35 points. Typical symptoms were found only in 14-22% of patients. The mean intensity of heartburn was 2.6 +/- 0.66 points, mean index of heartburn was 4.73 +/- 1.02 points. The incidence of atypical symptoms was three times higher than the incidence of typical symptoms (p < 0.05). According to the multinomial logistic regression analysis the combination of three atypical symptoms (hoarseness, throat clearing and globus pharyngeus) separated groups of the patients and healthy persons. The combination of these symptoms increases the odds ratio for laryngopharyngeal reflux disease 59.7 times. Idiopathic hoarseness as a single symptom increases the odds ratio for laryngopharyngeal reflux disease 85 times.
该研究旨在评估和比较72例患者和123名健康人喉咽反流病的典型症状(烧心、反酸)和非典型症状(声音嘶哑、清嗓、咽部异物感)的强度和发生率。58例(80.6%)喉咽反流病的诊断通过食管炎的内镜和组织学检查结果得以证实,14例(19.4%)通过奥美拉唑试验得以证实。症状强度通过症状强度与频率的乘积来计算。根据所得数据,喉咽反流病更常表现为非典型症状。在患者组中,声音嘶哑的平均强度为5.29±0.74分,声音嘶哑指数为7.06±1.35分。仅14%-22%的患者出现典型症状。烧心的平均强度为2.6±0.66分,烧心指数为4.73±1.02分。非典型症状的发生率比典型症状的发生率高3倍(p<0.05)。根据多项逻辑回归分析,三种非典型症状(声音嘶哑、清嗓和咽部异物感)的组合可区分患者组和健康人组。这些症状的组合使喉咽反流病的优势比增加59.7倍。特发性声音嘶哑作为单一症状使喉咽反流病的优势比增加85倍。