Arruda Henry Maria Aparecida Coelho de, Martins Regina Helena Garcia, Lerco Mauro Masson, Carvalho Lídia Raquel, Lamônica-Garcia Vânia Cristina
Department of Surgery and Orthopedics, Botucatu Medical School, São Paulo State University, SP, Brasil.
Arq Gastroenterol. 2011 Apr-Jun;48(2):98-103. doi: 10.1590/s0004-28032011000200003.
Gastroesophageal reflux disease is a chronic disease in which gastroduodenal contents reflux into the esophagus. The clinical picture of gastroesophageal reflux disease is usually composed by heartburn and regurgitation (typical manifestations). Atypical manifestations (vocal disturbances and asthma) may also be complaint.
To analyse the clinical, endoscopic, manometric and pHmetric aspects of patients suffering from gastroesophageal reflux disease associated with vocal disturbances.
Fifty patients with gastroesophageal reflux disease were studied, including 25 with vocal disturbances (group 1 - G1) and 25 without these symptoms (group 2 - G2). All patients were submitted to endoscopy, manometry and esophageal pHmetry (2 probes). The group 1 patients were submitted to videolaryngoscopy.
Endoscopic findings: non-erosive reflux disease was observed in 95% of G1 patients and 88% of G2. Videolaryngoscopy: vocal fold congestion, asymmetry, nodules and polyps were observed in G1 patients. Manometric findings: pressure in the lower esophageal sphincter (mm Hg): 11.6 ± 5.2 in G1 and 14.0 ± 6.2 in G2 (P = 0.14); pressure in the upper esophageal sphincter (mm Hg): 58.4 ± 15.9 in G1 and 69.5 ± 30.7 in the controls. pHmetric findings: De Meester index: 34.0 ± 20.9 in G1 and 15.4 ± 9.4 in G2 (P<0.001); number of reflux episodes in distal probe: 43.0 ± 20.4 in G1 and 26.4 ± 17.2 in G2 (P = 0.003); percentage of time with esophageal pH value lower than 4 units (distal sensor): 9.0% ± 6.4% in G1 and 3.4% ± 2.1% in G2 (P<0.001); number of reflux episodes in proximal probe: 7.5 ± 10.9 in G1 and 5.3 ± 5.7 in G2 (P = 0.38); percentage of time with esophageal pH values lower than 4 units (Proximal probe): 1.2 ± 2.7 in G1 and 0.5 ± 0.7 in G2 (P = 0.21).
胃食管反流病是一种慢性疾病，其中胃十二指肠内容物反流至食管。胃食管反流病的临床表现通常由烧心和反流（典型表现）组成。非典型表现（嗓音障碍和哮喘）也可能出现。
分析患有与嗓音障碍相关的胃食管反流病患者的临床、内镜、测压和pH监测方面的情况。
研究了50例胃食管反流病患者，包括25例有嗓音障碍的患者（第1组 - G1）和25例无这些症状的患者（第2组 - G2）。所有患者均接受内镜检查、测压和食管pH监测（双探头）。第1组患者接受视频喉镜检查。
内镜检查结果：95%的G1患者和88%的G2患者观察到非糜烂性反流病。视频喉镜检查：G1患者观察到声带充血、不对称、结节和息肉。测压结果：食管下括约肌压力（mmHg）：G1组为11.6±5.2，G2组为14.0±6.2（P = 0.14）；食管上括约肌压力（mmHg）：G1组为58.4±15.9，对照组为69.5±30.7。pH监测结果：De Meester指数：G1组为34.0±20.9，G2组为15.4±9.4（P<0.001）；远端探头反流发作次数：G1组为43.0±20.4，G2组为26.4±17.2（P = 0.003）；食管pH值低于4单位的时间百分比（远端传感器）：G1组为9.0%±6.4%，G2组为3.4%±2.1%（P<0.001）；近端探头反流发作次数：G1组为7.5±10.9，G2组为5.3±5.7（P = 0.38）；食管pH值低于4单位的时间百分比（近端探头）：G1组为1.2±2.7，G2组为0.5±0.7（P = 0.21）。
1）有嗓音障碍的患者在临床、内镜和测压方面的表现与无这些症状的患者无差异；2）有嗓音障碍的患者胃食管反流强度更高；3）无嗓音障碍的患者近端探头也可出现反流发作。
