Jacob P, Kahrilas P J, Herzon G
Department of Medicine, Northwestern University Medical School, Chicago, Illinois.
Gastroenterology. 1991 Feb;100(2):305-10. doi: 10.1016/0016-5085(91)90196-r.
Fiberoptic laryngoscopic examinations were performed on 40 patients with gastroesophageal reflux disease, 25 of whom had persistent laryngeal symptoms (dysphonia, cough, globus sensation, frequent throat clearing, or sore throat) and 15 without laryngeal symptoms who served as disease controls. Ten patients with laryngeal symptoms but none of the controls had laryngoscopic findings consistent with reflux laryngitis. Dual-site ambulatory pH recordings were obtained with the pH electrodes spaced 15 cm apart and with the proximal sensor positioned just distal to the upper esophageal sphincter. Patients in the three groups (disease controls: group 1; patients with symptoms but without laryngoscopic findings: group 2; and patients with both laryngeal symptoms and findings: group 3) were comparable in terms of age, smoking habit, the presence of esophagitis, and distal esophageal acid exposure. Proximal esophageal acid exposure was, however, significantly increased in groups 2 and 3, and nocturnal proximal esophageal acidification occurred in over half of these patients but in none of the group 1 patients. We conclude that the subset of reflux patients who experience laryngeal symptoms show significantly more proximal esophageal acid exposure (especially nocturnally) and often have laryngoscopic findings of posterior laryngitis not observed in control reflux patients.
对40例胃食管反流病患者进行了纤维喉镜检查，其中25例有持续的喉部症状（声音嘶哑、咳嗽、咽部异物感、频繁清嗓或咽痛），15例无喉部症状作为疾病对照。10例有喉部症状的患者中有反流性喉炎的喉镜检查结果，但对照组均无。采用pH电极间距为15 cm、近端传感器位于食管上括约肌远端的双位点动态pH监测。三组患者（疾病对照组：第1组；有症状但无喉镜检查结果的患者：第2组；有喉部症状且有检查结果的患者：第3组）在年龄、吸烟习惯、食管炎的存在情况以及食管远端酸暴露方面具有可比性。然而，第2组和第3组近端食管酸暴露显著增加，这些患者中超过一半出现夜间近端食管酸化，但第1组患者均未出现。我们得出结论，出现喉部症状的反流患者亚组显示近端食管酸暴露显著增加（尤其是夜间），且常有对照组反流患者未观察到的喉后部炎症的喉镜检查结果。
