24小时咽pH监测在喉咽反流病中的应用及临床特征
Utility of 24-hour pharyngeal pH monitoring and clinical feature in laryngopharyngeal reflux disease.
作者信息
Wang Gang, Qu Changmin, Wang Lei, Liu Hongdan, Han Haolun, Xu Bingxin, Zhou Ying, Li Baowei, Zhang Yiyan, Sun Zhezhe, Gong Jing, Li Lianyong, Wu Wei
机构信息
a Department of Otorhinolaryngology Head and Neck Surgery , Chinese People Liberation Army 306th Hospital , Beijing , China.
b Department of Gastroenterology , Chinese People Liberation Army 306th Hospital , Beijing , China.
出版信息
Acta Otolaryngol. 2019 Mar;139(3):299-303. doi: 10.1080/00016489.2019.1571280.
BACKGROUND
pH monitoring can reflect the changes in H in the airway.
OBJECTIVES
To explore the utility of pharyngeal pH monitoring in the diagnosis of laryngopharyngeal reflux disease (LPRD).
MATERIAL AND METHODS
Clinical data from 956 suspected LPRD patients from February 2016 to March 2018 were analyzed retrospectively.
RESULTS
One hundred forty-one patients had positive Ryan score. The positive rates of reflux symptom index (RSI), reflux finding score (RFS), RSI and RFS and RSI or RFS were 14.7%, 32.5%, 21.9%, 7.8% and 46.5%, respectively. The RFS in the positive Ryan score group was higher than that in the negative Ryan score group [(6 ± 3.5) vs. (4.8 ± 2.9)], while the RSI was not significantly different from that in the negative Ryan score group [(10.9 ± 8) vs. (11.3 ± 7.1)]. Regarding Ryan score as the gold standard in the diagnosis of LPRD, the sensitivity, specificity, positive and negative predictive value of identifying LPRD by RSI/RFS were 15.9%, 86.3%, 50.4% and 54%, respectively.
CONCLUSIONS
Ryan score, RSI and RFS have poor correlation in detecting LPRD. Some patients may be missed with the Ryan score as a diagnostic criterion.
SIGNIFICANCE
Pharyngeal pH monitoring is useful and more appropriate index is expected.
背景
pH监测可反映气道中氢离子的变化。
目的
探讨咽部pH监测在喉咽反流病（LPRD）诊断中的应用价值。
材料与方法
回顾性分析2016年2月至2018年3月956例疑似LPRD患者的临床资料。
结果
141例患者Ryan评分阳性。反流症状指数（RSI）、反流发现评分（RFS）、RSI与RFS及RSI或RFS的阳性率分别为14.7%、32.5%、21.9%、7.8%和46.5%。Ryan评分阳性组的RFS高于阴性组[（6±3.5）对（4.8±2.9）]，而RSI与阴性组无显著差异[（10.9±8）对（11.3±7.1）]。以Ryan评分作为LPRD诊断的金标准，RSI/RFS诊断LPRD的敏感性、特异性、阳性和阴性预测值分别为15.9%、86.3%、50.4%和54%。
结论
Ryan评分、RSI和RFS在检测LPRD方面相关性较差。以Ryan评分为诊断标准可能会漏诊部分患者。
意义
咽部pH监测有用，期待更合适的指标。
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