韩国伴有喉咽表现的胃食管反流病
Gastroesophageal reflux disease with laryngopharyngeal manifestation in Korea.
作者信息
Park Ju Hee, Lee Dong Ho, Kim Ji Yeon, Park So Youn, Yoon Hyuk, Park Young Soo, Kim Nayoung, Jeong Sook-Hyang, Kim Jin-Wook, Lee Sang Hyub, Hwang Jin Hyeok, Jung Hyun Chae
机构信息
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
出版信息
Hepatogastroenterology. 2012 Nov-Dec;59(120):2527-9. doi: 10.5754/hge10294.
BACKGROUND/AIMS: Globus pharyngeus and hoarseness are common extraesophageal manifestations inpatients with gastroesophageal reflux disease. The aim of this study was to evaluate the clinical characteristics, laryngoscopic findings, endoscopic findings, and response to proton pump inhibitors in patients presenting laryngeal symptoms suspected to be caused by GERD.
METHODOLOGY
We retrospectively reviewed the medical records of 160 patients that presented with globus and/or hoarseness and underwent acid suppression therapy under the impression of GERDfrom May 2003 to April 2009.
RESULTS
Sixty patients(37.5%) reported classical GERD symptoms such as heartburn and/or acid regurgitation. Sixty nine percent(69%) of patients (95/138) showed abnormal laryngoscopic findings such as laryngeal edema/hyperemia, vocal cord swelling/hyperemia, arytenoids swelling/hyperemia, vocal cord nodule, vocal cord polyp, post-glottic swelling/hyperemia, etc. Endoscopically, 41.9%(39/93) showed normal endoscopic findings and 49.5% (46/93) showed minimal changes. 8.6% (8/93)of patients showed erosive reflux disease. Therapeutic response was not significantly different among patients treated with standard dose PPIs (44/58, 75.9%),half dose PPIs (17/22, 77.3%), or revaprazan (18/21,85.7%).
CONCLUSIONS
Among patients with globus pharyngeus and/or hoarseness and suspected GERD, only 37.5% reported classical symptoms of GERD such as heartburn and/or acid regurgitation, 69% showed ab-normal laryngoscopic findings, 58.1% showed abnormal endoscopic findings, and 80% showed therapeutic response to acid suppression therapy.
背景/目的:咽异感症和声音嘶哑是胃食管反流病患者常见的食管外表现。本研究旨在评估疑似由胃食管反流病(GERD)引起喉部症状的患者的临床特征、喉镜检查结果、内镜检查结果以及对质子泵抑制剂的反应。
方法
我们回顾性分析了2003年5月至2009年4月期间160例出现咽异感症和/或声音嘶哑并在GERD诊断印象下接受抑酸治疗的患者的病历。
结果
60例患者(37.5%)报告有烧心和/或反酸等典型的GERD症状。69%(95/138)的患者喉镜检查结果异常,如喉部水肿/充血、声带肿胀/充血、杓状软骨肿胀/充血、声带小结、声带息肉、声门后肿胀/充血等。内镜检查方面,41.9%(39/93)结果正常,49.5%(46/93)有轻微改变。8.6%(8/93)的患者有糜烂性反流病。接受标准剂量质子泵抑制剂治疗的患者(44/58,75.9%)、半剂量质子泵抑制剂治疗的患者(17/22,77.3%)或雷贝拉唑治疗的患者(18/21,85.7%)之间的治疗反应无显著差异。
结论
在有咽异感症和/或声音嘶哑且疑似GERD的患者中,只有37.5%报告有烧心和/或反酸等典型的GERD症状,69%喉镜检查结果异常,58.1%内镜检查结果异常,80%对抑酸治疗有反应。