Kimura Yurika, Sugiura Mutsumi, Kato Tomofumi, Makino Nao, Ohmae Yukio, Kishimoto Seiji
Department of Otolaryngology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakaecho, Itabashi-ku, Tokyo-to, Japan 173-0015.
Ann Otol Rhinol Laryngol. 2010 Sep;119(9):631-5. doi: 10.1177/000348941011900911.
Laryngopharyngeal reflux disease (LPRD) is an important cause of throat discomfort in the elderly. Our objective was to investigate the usefulness of barium swallow studies for the diagnosis of LPRD.
The subjects were 59 patients at least 60 years of age with LPRD suspected on laryngoscopic findings. We evaluated esophageal clearance using a barium swallow study and the upper gastrointestinal tract endoscopic findings of gastroesophageal reflux disease according to the revised Los Angeles classification, and correlated these findings with the effect of rabeprazole, a proton pump inhibitor.
Among subjects with positive reflux findings in the esophageal phase of the barium swallow, rabeprazole was significantly effective (p = 0.0025). To identify nonerosive reflux disease, we analyzed the 50 cases with a negative Los Angeles classification of upper gastrointestinal tract endoscopic findings. Rabeprazole was again significantly effective in patients with positive findings for esophageal reflux (p = 0.0025).
Among elderly patients with suspected LPRD, there was a positive correlation between impaired esophageal clearance on the barium swallow study and the effectiveness of rabeprazole. The barium swallow study could be a screening test for LPRD in elderly patients with throat discomfort.
喉咽反流病（LPRD）是老年人咽喉不适的重要原因。我们的目的是研究吞钡检查对LPRD诊断的实用性。
研究对象为59例年龄至少60岁、喉镜检查怀疑患有LPRD的患者。我们通过吞钡检查评估食管清除功能，并根据修订的洛杉矶分类法评估胃食管反流病的上消化道内镜检查结果，将这些结果与质子泵抑制剂雷贝拉唑的疗效相关联。
在吞钡食管期反流结果为阳性的受试者中，雷贝拉唑具有显著疗效（p = 0.0025）。为了识别非糜烂性反流病，我们分析了50例上消化道内镜检查洛杉矶分类为阴性的病例。雷贝拉唑对食管反流结果为阳性的患者同样具有显著疗效（p = 0.0025）。
在疑似LPRD的老年患者中，吞钡检查显示的食管清除功能受损与雷贝拉唑的疗效之间存在正相关。吞钡检查可为咽喉不适的老年患者筛查LPRD。
