Zhao Yu, Han Honglei, Lu Qiuping, Liang Yan
Department of Otolaryngology-Head and Neck Surgery, China-Japan Friendship Hospital, Beijing, People's Republic of China.
Gastroesophageal Surgery Department, PLA Rocket Force Characteristic Medical Center, Beijing, China.
Ear Nose Throat J. 2023 Oct 13:1455613231205393. doi: 10.1177/01455613231205393.
To summarize the characteristics of laryngopharyngeal reflux in patients with chronic cough induced by gastroesophageal reflux disease (GERD). The clinical data of patients with chronic cough induced by GERD treated at our hospital were retrospectively analyzed, including their reflux symptom index (RSI), reflux finding scores (RFS), and results of oropharyngeal pH monitoring. There were 44 patients in total, including 21 males and 23 females. The average history of chronic cough was 29.60 (29.60 ± 37.60) months. In addition to coughing, all patients had at least 2 symptoms of laryngopharyngeal reflux disease (LPRD), and their RSI averaged 15.66 (15.66 ± 6.33). The most frequent symptoms were cough, throat clearing, excessive phlegm, or postnasal drip. All patients had LPRD signs, with an average RFS of 10.89 (10.89 ± 2.81). The most frequent signs were erythema or hyperemia/vocal cord edema, posterior commissure hypertrophy, and diffuse laryngeal edema. There were 42 patients (42/44, 95.45%) whose RSI and/or RFS were abnormal. Oropharyngeal pH monitoring identified 10 patients (10/44, 22.72%) with abnormal Ryan scores. All patients with chronic cough induced by GERD had symptoms and signs of LPRD, and most of them had an abnormal RSI and/or RFS and could be diagnosed with suspect LPRD. A part of the patients had LPR episodes according to Dx-pH monitoring, most of which occurred in the upright position. These results indicated that most patients with chronic cough induced by GERD may have suspected LPRD simultaneously and that cough was one of their LPRD symptoms.
总结胃食管反流病(GERD)所致慢性咳嗽患者的喉咽反流特征。回顾性分析我院收治的GERD所致慢性咳嗽患者的临床资料,包括反流症状指数(RSI)、反流发现评分(RFS)及口咽pH监测结果。共44例患者,其中男性21例,女性23例。慢性咳嗽平均病程为29.60(29.60±37.60)个月。除咳嗽外,所有患者均至少有2种喉咽反流病(LPRD)症状,RSI平均为15.66(15.66±6.33)。最常见的症状为咳嗽、清嗓、痰液过多或鼻后滴漏。所有患者均有LPRD体征,RFS平均为10.89(10.89±2.81)。最常见的体征为红斑或充血/声带水肿、后联合肥大及弥漫性喉水肿。42例患者(42/44,95.45%)的RSI和/或RFS异常。口咽pH监测发现10例患者(10/44,22.72%)Ryan评分异常。所有GERD所致慢性咳嗽患者均有LPRD症状和体征,大多数患者RSI和/或RFS异常,可诊断为疑似LPRD。根据Dx-pH监测,部分患者有LPR发作,大多数发作发生在直立位。这些结果表明,大多数GERD所致慢性咳嗽患者可能同时存在疑似LPRD,且咳嗽是其LPRD症状之一。
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