Byrne P J, Power C, Lawlor P, Ravi N, Reynolds J V
University Department of Surgery, St James's Hospital, Dublin, Ireland.
Dis Esophagus. 2006;19(5):377-81. doi: 10.1111/j.1442-2050.2006.00600.x.
Laryngopharyngeal reflux (LPR) has been extensively studied in patients with laryngeal signs and symptoms, gastroesophageal reflux being identified in approximately 50%. Few studies have investigated the incidence and significance of LPR in GERD patients. Two-hundred and seventy-six consecutive patients referred with symptoms of gastroesophageal reflux had dual probe 24 h pH, esophageal manometry, GERD and ENT questionnaires. LPR was defined as at least three pharyngeal reflux events less than pH 5.0 with corresponding esophageal reflux, but excluding meal periods. Fourty-two percent of patients were positive for LPR on 24 h pH monitoring and 91.3% corresponded with an abnormal esophageal acid score. Distal esophageal acid exposure was significantly greater (P < 0.001) in patients with LPR but symptoms of GERD and regurgitation scores showed no significant differences between patients with positive and negative LPR on 24 h pH. There was no significant difference between the incidence of LPR in patients with or without laryngeal symptoms. There is a high incidence of LPR in patients with GERD but its significance for laryngeal symptoms is tenuous. Fixed distance dual probe pH monitoring allows documentation of conventional esophageal reflux and LPR.
喉咽反流（LPR）在有喉部体征和症状的患者中已得到广泛研究，约50%的患者被诊断为胃食管反流。很少有研究调查LPR在胃食管反流病（GERD）患者中的发生率及意义。连续276例因胃食管反流症状就诊的患者接受了双探头24小时pH监测、食管测压、GERD问卷及耳鼻喉科问卷。LPR定义为至少三次pH值低于5.0的咽反流事件且伴有相应的食管反流，但进食期除外。42%的患者24小时pH监测显示LPR阳性，91.3%的患者食管酸评分异常。LPR患者的食管远端酸暴露显著更高（P<0.001），但GERD症状和反流评分在24小时pH监测LPR阳性和阴性患者之间无显著差异。有或无喉部症状的患者中LPR的发生率无显著差异。GERD患者中LPR发生率较高，但其对喉部症状的意义尚不明确。固定距离双探头pH监测可记录传统的食管反流和LPR。
