Departments of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan, ROC.
Departments of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan, ROC.
Sci Rep. 2021 Oct 14;11(1):20392. doi: 10.1038/s41598-021-99927-0.
Laryngopharyngeal reflux symptom is a troublesome upper esophageal problem, and reflux symptom index (RSI) is commonly applied for the assessment of clinical severity. We investigated the relationship between the upper esophageal sphincter impedance integral (UESII) and RSI scores in this study. Totally 158 subjects with high-resolution esophageal impedance manometry (HRIM) with RSI questionnaire assessment were recruited. There are 57 (36.08%), 74 (46.84%), 21 (13.29%), and 6 (3.79%) patients were categorized as normal, ineffective esophageal motility disorder, absent contractility, and achalasia by HRIM examination, respectively. Subjects with RSI > 13 were noted to have lower UESII than others with RSI ≦ 13 (7363.14 ± 1085.58 vs. 11,833.75 ± 918.77 Ω s cm; P < 0.005). The ROC analysis yielded a UESII cutoff of < 2900 Ω s cm for the best prediction of subjects with RSI > 13 (P = 0.002). Both female gender and UESII cutoff of < 2900 Ω s cm were significant predictors of RSI > 13 in logistic regression analysis (OR = 3.84 and 2.83; P = 0.001 and 0.01; respectively). Lower UESII on HRIM study, indicating poor bolus transit of UES during saline swallows, is significantly associated with prominent laryngopharyngeal reflux symptoms scored by RSI score.
咽喉反流症状是一种棘手的上食管问题，反流症状指数（RSI）常用于评估临床严重程度。本研究旨在探讨上食管括约肌阻抗积分（UESII）与 RSI 评分之间的关系。共纳入 158 例接受高分辨率食管阻抗测压（HRIM）和 RSI 问卷评估的患者。根据 HRIM 检查，57 例（36.08%）、74 例（46.84%）、21 例（13.29%）和 6 例（3.79%）患者分别归类为正常、无效食管动力障碍、无收缩力和贲门失弛缓症。RSI＞13 的患者 UESII 明显低于 RSI≤13 的患者（7363.14±1085.58 vs. 11833.75±918.77 Ω·s·cm；P＜0.005）。ROC 分析得出，UESII＜2900 Ω·s·cm 时对 RSI＞13 的预测最佳（P＝0.002）。Logistic 回归分析显示，女性和 UESII＜2900 Ω·s·cm 是 RSI＞13 的显著预测因素（OR＝3.84 和 2.83；P＝0.001 和 0.01；分别）。HRIM 研究中 UESII 降低，提示UES 在吞咽盐水时的食团转运较差，与 RSI 评分所示明显的咽喉反流症状显著相关。
