Gastroenterology Unit, Department of Medicine, Raja Isteri Pengiran Anak Saleha Hospital, Bandar Seri Begawan BA1710, Brunei Darussalam.
Eur Arch Otorhinolaryngol. 2010 Nov;267(11):1793-9. doi: 10.1007/s00405-010-1259-2. Epub 2010 May 1.
Laryngopharyngeal reflux (LPR) is common in clinical practice. Heterotopic gastric mucosal patch of the proximal esophagus (HGMP) is reported to cause LPR symptoms. This study assessed the prevalence of LPR symptoms and correlation with the size of HGMP. Four hundred and sixty-two patients undergoing endoscopy were carefully questioned regarding LPR symptoms experienced in the previous 12 weeks. The size of the HGMP was assessed and documented during endoscopy. Clinicopathological classifications were assigned (types I-V) accordingly. HGMP [median one patch (range 1-3), median size 15 mm [3-35] was detected in 26 (19 HGM type I and 7 HGM type II] patients giving a prevalence of 5.6%. Among the indications, there were significantly more LPR symptoms as referral indications among patients with HGMP. There were no significant differences in the endoscopic findings. On specific enquiries, significantly more HGMP patients had experienced any LPR symptoms (73.1 vs. 25.9%, p < 0.001) specifically chronic cough (p = 0.002), throat discomfort/hoarseness (p < 0.001), globus sensation (p = 0.004), regurgitation (p < 0.001). HGMP patients also had more heartburn (p = 0.001). Larger HGMP (≥ 15 mm) was only associated with more chronic cough (p = 0.022). In conclusion, patients with HGMP have significantly more LPR symptoms. However, most were mild and detected through specific enquiries. Interestingly, the size of HGMP did not significantly affect the prevalence of LPR symptoms.
咽喉反流(LPR)在临床实践中很常见。据报道,近端食管异位胃黏膜斑(HGMP)可引起 LPR 症状。本研究评估了 LPR 症状的患病率及其与 HGMP 大小的相关性。
对 462 例行内镜检查的患者进行了仔细询问,了解其在过去 12 周内经历的 LPR 症状。在进行内镜检查时评估并记录了 HGMP 的大小。根据相应的临床病理分类(I-V 型)进行分类。
在 26 名患者(19 名 HGM Ⅰ型和 7 名 HGM Ⅱ型)中发现了 HGMP[中位数为 1 个斑块(范围 1-3),中位数大小为 15mm[3-35],患病率为 5.6%。在这些指征中,以 LPR 症状为指征的患者中 HGMP 的比例明显更高。内镜检查结果无明显差异。在具体询问时,HGMP 患者经历过更多的 LPR 症状(73.1%比 25.9%,p<0.001),特别是慢性咳嗽(p=0.002)、咽喉不适/声音嘶哑(p<0.001)、球感(p=0.004)、反流(p<0.001)。HGMP 患者也有更多的烧心(p=0.001)。
较大的 HGMP(≥15mm)仅与更多的慢性咳嗽相关(p=0.022)。
总之,HGMP 患者有明显更多的 LPR 症状。然而,大多数症状较轻,通过特定的询问才能发现。有趣的是,HGMP 的大小并没有显著影响 LPR 症状的患病率。