Su Yiliang, Shen Li, Zhang Fen, Jiang Xing, Jin Xiaofeng, Zhang Yuan, Hu Yang, Zhou Ying, Li Qiuhong, Li Huiping
Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.
Front Pharmacol. 2021 Aug 12;12:724286. doi: 10.3389/fphar.2021.724286. eCollection 2021.
Patients with idiopathic pulmonary fibrosis (IPF) often have irritating persistent dry cough. Possible correlations between dry cough and laryngopharyngeal reflux (LPR) remain unclear. 44 patients with IPF and 30 healthy individuals underwent 24 h laryngopharyngeal pH monitoring. Ryan index score was calculated. Patients' demographic and clinical data were collected. 44 patients with IPF and 30 healthy individuals were included. The proportions of men and smokers were significantly higher in IPF group than control group (All < 0.01). The average laryngopharyngeal pH value for 24 h was similar in the IPF (7.11 ± 0.08) group and control group (7.09 ± 0.06). According to the percentage duration of pH < 6.5, pH6.5-7.5, and pH > 7.5 in the overall measure duration, the patients were classified into three pH groups. In entire pH monitoring duration, the proportion of pH > 7.5 group in IPF patients was higher than control group; at upright position, the proportion of pH > 7.5 group in IPF patients was higher than control group; at supine position, the proportion of pH < 6.5 group in IPF patients was higher than control group (All < 0.01). Seven patients had Ryan index score>9.41 at upright position. All patients had Ryan index score<6.79 at supine position. Four patients showed significantly higher and one patient had significantly lower average pH at coughing than the overall average pH (All < 0.05). Patients with IPF may have LPR. Basic and acidic LPR may likely occur at upright and supine position, respectively. Ryan index may not accurately reflect LPR in patients with IPF.
特发性肺纤维化（IPF）患者常伴有刺激性持续性干咳。干咳与喉咽反流（LPR）之间的潜在关联尚不清楚。44例IPF患者和30名健康个体接受了24小时喉咽pH监测。计算Ryan指数评分。收集患者的人口统计学和临床数据。纳入44例IPF患者和30名健康个体。IPF组男性和吸烟者的比例显著高于对照组（均P<0.01）。IPF组（7.11±0.08）和对照组（7.09±0.06）24小时平均喉咽pH值相似。根据整个测量期间pH<6.5、pH6.5 - 7.5和pH>7.5的持续时间百分比，将患者分为三个pH组。在整个pH监测期间，IPF患者中pH>7.5组的比例高于对照组；直立位时，IPF患者中pH>7.5组的比例高于对照组；仰卧位时，IPF患者中pH<6.5组的比例高于对照组（均P<0.01）。7例患者直立位时Ryan指数评分>9.41。所有患者仰卧位时Ryan指数评分<6.79。4例患者咳嗽时的平均pH值显著高于总体平均pH值，1例患者显著低于总体平均pH值（均P<0.05）。IPF患者可能存在LPR。碱性和酸性LPR可能分别发生于直立位和仰卧位。Ryan指数可能无法准确反映IPF患者的LPR。
