Pendleton Hillevi, Ahlner-Elmqvist Marianne, Olsson Rolf, Thorsson Ola, Hammar Oskar, Jannert Magnus, Ohlsson Bodil
Department of Clinical Sciences, Division of Oto-Rhino-Laryngology, Skåne University Hospital, Malmö, Lund University, Lund, Sweden.
BMC Ear Nose Throat Disord. 2013 Sep 9;13(1):11. doi: 10.1186/1472-6815-13-11.
Laryngo-pharyngeal reflux (LPR) is assumed to be the most common cause of posterior laryngitis (PL). Since LPR is found in healthy subjects, and PL patients are not improved by acid-reducing therapy, other aetiologies to PL must be considered. The aims of this study in PL were to investigate the prevalence of acid reflux in the proximal oesophagus and functional gastrointestinal symptoms, to analyse motilin levels in plasma, and to assess health-related quality of life (HRQOL) before and after treatment.
Forty-six patients (26 women), with verified PL, median age 55 (IQR 41-68) years, were referred to oesophago-gastro-duodenoscopy and 24-h pH monitoring. Plasma motilin was analysed. The 36-item Short-Form questionnaire was completed at inclusion and at follow-up after 43±14 months, when also the Visual Analogue Scale for Irritable Bowel Syndrome was completed. Values were compared to controls. Treatment and relief of symptoms were noted from medical records.
Thirty-four percent had proximal acid reflux and 40% showed signs of distal reflux. Ninety-four percent received acid-reducing treatment, with total relief of symptoms in 17%. Patients with reflux symptoms had lower plasma motilin levels compared to patients without reflux symptoms (p = 0.021). The HRQOL was impaired at inclusion, but improved over time. Patients, especially men, had more functional gastrointestinal symptoms than controls.
This study indicates that a minority of patients with PL has LPR and is cured by acid-reducing therapy. Disturbed plasma motilin levels and presence of functional gastrointestinal symptoms are found in PL. The impaired HRQOL improves over time.
喉咽反流（LPR）被认为是喉后部炎症（PL）最常见的病因。由于在健康受试者中也发现有LPR，并且PL患者不会因抑酸治疗而改善，因此必须考虑PL的其他病因。本研究在PL患者中的目的是调查食管近端酸反流的患病率和功能性胃肠道症状，分析血浆胃动素水平，并评估治疗前后的健康相关生活质量（HRQOL）。
46例经证实患有PL的患者（26例女性），中位年龄55岁（四分位间距41 - 68岁），接受了食管胃十二指肠镜检查和24小时pH监测。分析血浆胃动素。在纳入时以及43±14个月后的随访时完成36项简短问卷，此时还完成了肠易激综合征视觉模拟量表。将数值与对照组进行比较。从病历中记录治疗情况和症状缓解情况。
34%的患者有食管近端酸反流，40%有远端反流迹象。94%的患者接受了抑酸治疗，17%的患者症状完全缓解。与无反流症状的患者相比，有反流症状的患者血浆胃动素水平较低（p = 0.021）。纳入时HRQOL受损，但随时间改善。患者，尤其是男性，比对照组有更多的功能性胃肠道症状。
本研究表明，少数PL患者有LPR且可通过抑酸治疗治愈。PL患者存在血浆胃动素水平紊乱和功能性胃肠道症状。受损的HRQOL随时间改善。
