Siupsinskiene Nora, Adamonis Kestutis, Toohill Robert J
ENT Department, Kaunas Medical University Hospital, Kaunas, Lithuania.
Laryngoscope. 2007 Mar;117(3):480-4. doi: 10.1097/MLG.0b013e31802d83cf.
To evaluate and compare quality of life (QL) parameters in patients with laryngopharyngeal reflux (LPR) versus healthy controls, to determine the impact of clinical signs to QL, and to assess changes in QL parameters after treatment.
Prospective, open, clinical study.
One hundred outpatients with LPR and 109 healthy voice controls were enrolled. LPR patients underwent endoscopy and received omeprazole for 3 months. Results of endoscopy revealed 79 patients without esophagitis and 21 with, giving two subgroups of LPR patients. QL was evaluated using voice handicap index (VHI), hospital anxiety and depression scale, disability in social activities, and well-being in general (W-BVAS).
The mean scores for total VHI and functional, physical, and emotional functioning domain subscales were found to be significantly higher in LPR patients versus controls (P < .0001), with no difference among LPR subgroups. Abnormal anxiety was one third in both LPR subgroups versus 6.4% of controls (P < .001). Both LPR subgroups patients had significantly reduced social activities and significantly lower mean W-BVAS score than controls. LPR symptoms had a significant relation with all tested QL parameters, whereas laryngoscopic findings had a significant relation with VHI and W-BVAS only. All mean QL parameters scores improved after 3-month omeprazole treatment.
QL in LPR patients with or without esophagitis is impaired significantly in many aspects. Impairment of QL is more associated with symptoms than laryngoscopic findings. Treatment with omeprazole significantly improved QL in both LPR subgroups patients.
评估并比较喉咽反流(LPR)患者与健康对照者的生活质量(QL)参数,确定临床体征对生活质量的影响,并评估治疗后QL参数的变化。
前瞻性、开放性临床研究。
纳入100例LPR门诊患者和109例健康嗓音对照者。LPR患者接受内镜检查,并接受奥美拉唑治疗3个月。内镜检查结果显示,79例患者无食管炎,21例有食管炎,由此将LPR患者分为两个亚组。使用嗓音障碍指数(VHI)、医院焦虑抑郁量表、社交活动障碍和总体幸福感量表(W-BVAS)评估生活质量。
发现LPR患者的总VHI及其功能、身体和情感功能领域子量表的平均得分显著高于对照组(P <.0001),LPR亚组之间无差异。两个LPR亚组中异常焦虑的发生率均为三分之一,而对照组为6.4%(P <.001)。两个LPR亚组患者的社交活动均显著减少,平均W-BVAS得分显著低于对照组。LPR症状与所有测试的QL参数均有显著相关性,而喉镜检查结果仅与VHI和W-BVAS有显著相关性。奥美拉唑治疗3个月后,所有QL参数的平均得分均有所改善。
有无食管炎的LPR患者在许多方面的生活质量均显著受损。生活质量受损与症状的相关性大于喉镜检查结果。奥美拉唑治疗显著改善了两个LPR亚组患者的生活质量。