Bardan Eytan
Gastroenterology Department, Chaim Sheba Medical Center, Sackler School of Medicine, Tel-Hashomer, Israel.
Am J Med. 2003 Aug 18;115 Suppl 3A:78S-80S. doi: 10.1016/s0002-9343(03)00202-x.
Pharyngeal acid reflux events may be significant in the pathogenesis of various supraesophageal manifestations of gastroesophageal reflux disease. Intragroup variation and an extensive overlap among subject groups and normal controls make proximal esophageal 24-hour pH monitoring studies unreliable for the diagnosis of pharyngeal reflux. However, the clinical value of pharyngeal pH monitoring still remains uncertain. A 24-hour pharyngeal pH monitoring study has shown that at least some pharyngeal reflux events occur in most healthy subjects, mainly in the upright position. Based on these data, values for the upper limits of normal for total pharyngeal acid exposure time and pharyngeal acid events have been determined. This study provides clinicians with reference values for physiologic pharyngeal reflux, but the parameters of abnormal pharyngeal reflux events are still unknown. More research is needed before this practice can become part of the routine evaluation of patients with pharyngeal, laryngeal, respiratory, or ear, nose, and throat symptoms or disorders.
咽酸性反流事件在胃食管反流病的各种食管上表现的发病机制中可能具有重要意义。组内变异以及受试者组与正常对照组之间存在广泛重叠，使得近端食管24小时pH监测研究对于咽反流的诊断不可靠。然而，咽pH监测的临床价值仍不确定。一项24小时咽pH监测研究表明，大多数健康受试者至少会发生一些咽反流事件，主要发生在直立位。基于这些数据，已确定了咽总酸暴露时间和咽酸事件的正常上限值。本研究为临床医生提供了生理性咽反流的参考值，但异常咽反流事件的参数仍不清楚。在这种做法成为对有咽部、喉部、呼吸或耳鼻喉症状或疾病的患者进行常规评估的一部分之前，还需要更多的研究。
