Kowalik Katarzyna, Krzeski Antoni
Department of Otolaryngology, Division of Medicine and Dentistry, Medical University of Warsaw; Poland.
Department of Otolaryngology, Division of Medicine and Dentistry, Medical University of Warsaw, Poland.
Otolaryngol Pol. 2017 Dec 30;71(6):7-13. doi: 10.5604/01.3001.0010.7194.
Laryngopharyngeal reflux (LPR) is a common defect among laryngological and phoniatric patients. Although LPR is categorized as a superficial gastroesophageal reflux disease (GERD), differential diagnosis should treat these two diseases separately. LPR symptoms can be assessed in the interview using as a tool the reflux symptom index (RSI). In addition, changes in the larynx that occur during LPR might be seen during laryngoscopy and classified according to the reflux finding score (RFS). One of the main mucosal irritants in LPR is pepsin which digests proteins and impairs the functions of the upper respiratory tract cells by affecting carbonate anhydrase (CAIII) and the Sep 70 protein. Pepsin initiates inflammatory changes within the larynx, nasopharynx and nasal cavity. The use of pepsin detection in upper and lower throat secretions is a new direction in LPR diagnostics.
喉咽反流（LPR）是喉科和嗓音科患者中常见的病症。尽管LPR被归类为一种浅表性胃食管反流病（GERD），但鉴别诊断应将这两种疾病分开对待。在问诊时，可以使用反流症状指数（RSI）作为工具来评估LPR症状。此外，LPR期间发生的喉部变化可能在喉镜检查中观察到，并根据反流发现评分（RFS）进行分类。LPR中主要的黏膜刺激物之一是胃蛋白酶，它能消化蛋白质，并通过影响碳酸酐酶（CAIII）和Sep 70蛋白来损害上呼吸道细胞的功能。胃蛋白酶会引发喉、鼻咽和鼻腔内的炎症变化。检测上、下咽喉分泌物中的胃蛋白酶是LPR诊断的一个新方向。
