Li C F, Zhang L H, Wang W L, Cao J, Wang Y G, Zhao Y X
Department of Otorhinolaryngology Head and Neck Surgery, Peking University People's Hospital, Beijing 100044, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020 Mar 7;55(3):241-248. doi: 10.3760/cma.j.issn.1673-0860.2020.03.010.
To obtain the prevalence laryngopharyngeal reflux disease (LPRD), anxiety and depression in otorhinolaryngology outpatients and to explore the role of mental and psychological factors (anxiety and depression) in their pathogenesis. A questionnaire survey of reflux symptom index(RSI) scale and hospital anxiety and depression (HAD) scale were used to report 1 111 cases of outpatients in Department of Otorhinolaryngology Head and Neck Surgery, Peking University People's Hospital, from July 2017 to June 2018 (486 males, 625 females, age of 18-96 years old, median age of 38[30,53] years old) and to obtain the prevalence of LPRD, anxiety and depression. RSI-positive patients were selected in the case group, and RSI-negative patients were selected in the control group. The differences in HAD scores between the two groups were compared, and the risk factors of laryngopharyngeal reflux were analyzed. Statistical analysis was performed using SPSS 20.0 software. There were 151 cases in the case group and 960 cases in the control group. The prevalence of LPRD was 13.59% (151/1 111).There was no significant difference in the prevalence of LPRD between different genders (0.05). The prevalence rate was the highest in the 18-40 age group, and the difference in the prevalence of all age groups (18~ 40 years old; 41-65 years old; >65 years old) was statistically significant (0.05). The prevalence of LPRD among smokers and non-drinkers was higher than that of non-smokers and non-drinkers and the prevalence of the two groups was statistically significant (0.05). The most common symptoms of the RSI scale were pharyngeal foreign body sensation (92.72%,140/151), persistent clearing throat (88.74%,124/151), excessive sputum or nasal reflux (82.12%, 124/151). There were significant statistical differences between the two groups (0.05). Ninty-one patients with anxiety, the prevalence was 8.19%(91/1 111); 76 patients with depression, the prevalence was 6.84%(76/1 111).Among the LPRD patients, the hospital anxiety scale scored 29.14% (44/151), and the hospital depression scale scored 17.22% (26/151). The scores of anxiety symptoms and depressive symptoms in the LPRD group were higher than those in the non-LPRD group. The above scores were statistically significant (0.05). Logistic regression analysis showed that smoking, anxiety and symptoms of gastroesophageal reflux disease were independent risk factors for laryngopharyngeal reflux. The prevalences of LPRD, anxiety and depression in the otorhinolaryngology clinic are 13.59%, 8.19% and 6.84%, respectively. Among patients with laryngopharyngeal reflux, the prevalence of anxiety is 29.14%, and the prevalence of depression is 17.22%. Age, smoking, drinking, alcohol consumption, education level, course of disease, symptoms of gastroesophageal reflux disease, pharyngeal foreign body sensation, etc. are related to LPRD. Mental factors (anxiety and depression) may play a role in LPRD. Smoking, anxiety symptoms and symptoms of gastroesophageal reflux disease are closely related to the incidence of LPRD.
为了解耳鼻咽喉科门诊患者中喉咽反流病(LPRD)、焦虑和抑郁的患病率,并探讨心理因素(焦虑和抑郁)在其发病机制中的作用。采用反流症状指数(RSI)量表和医院焦虑抑郁(HAD)量表对北京大学人民医院耳鼻咽喉头颈外科2017年7月至2018年6月的1111例门诊患者(男486例,女625例,年龄18 - 96岁,中位年龄38[30,53]岁)进行问卷调查,以获取LPRD、焦虑和抑郁的患病率。病例组选取RSI阳性患者,对照组选取RSI阴性患者。比较两组HAD评分差异,分析喉咽反流的危险因素。使用SPSS 20.0软件进行统计分析。病例组151例,对照组960例。LPRD患病率为13.59%(151/1111)。不同性别LPRD患病率差异无统计学意义(P>0.05)。18 - 40岁年龄组患病率最高,各年龄组(18~40岁;41 - 65岁;>65岁)患病率差异有统计学意义(P<0.05)。吸烟且不饮酒者LPRD患病率高于不吸烟且不饮酒者,两组患病率差异有统计学意义(P<0.05)。RSI量表最常见症状为咽部异物感(92.72%,140/151)、持续清嗓(88.74%,124/151)、痰液过多或鼻反流(82.12%,124/151)。两组间差异有统计学意义(P<0.05)。焦虑患者91例,患病率为8.19%(91/1111);抑郁患者76例,患病率为6.84%(76/1111)。LPRD患者中,医院焦虑量表评分者占29.14%(44/151),医院抑郁量表评分者占17.22%(26/151)。LPRD组焦虑症状和抑郁症状评分高于非LPRD组。上述评分差异有统计学意义(P<0.05)。Logistic回归分析显示,吸烟、焦虑和胃食管反流病症状是喉咽反流的独立危险因素。耳鼻咽喉科门诊中LPRD、焦虑和抑郁的患病率分别为13.59%、8.19%和6.84%。喉咽反流患者中,焦虑患病率为29.14%,抑郁患病率为17.22%。年龄、吸烟、饮酒、酒精摄入量、文化程度、病程、胃食管反流病症状、咽部异物感等与LPRD有关。心理因素(焦虑和抑郁)可能在LPRD中起作用。吸烟、焦虑症状和胃食管反流病症状与LPRD的发生密切相关。