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慢性咽喉反流症状患者与病理性酸反流患者的社会心理负担。

Psychosocial burden in patients with chronic laryngopharyngeal symptoms with and without pathologic acid reflux.

机构信息

Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, California, USA.

Rome Foundation Research Institute, Raleigh, North Carolina, USA.

出版信息

Neurogastroenterol Motil. 2024 Sep;36(9):e14852. doi: 10.1111/nmo.14852. Epub 2024 Jun 24.

Abstract

BACKGROUND

Patients with chronic laryngopharyngeal symptoms, with or without pathologic reflux, frequently have poor response to standard therapies, which may be a result of overlapping cognitive-affective processes. Therefore, the aims of this study included measuring psychosocial distress and laryngeal-specific cognitive distress in patients with chronic laryngopharyngeal symptoms (LPS) as well as comparing these among laryngeal symptomatic patients with and without conclusive gastroesophageal reflux disease (GERD).

METHODS

This prospective, single-center study enrolled adults with chronic LPS from 9/22 to 6/23. Patients completed eight questionnaires on quality of life, symptom burden, and psychosocial distress. The laryngeal cognitive affective tool (LCAT) assessed laryngeal-specific hypervigilance and anxiety; LCAT scores ≥33 were elevated. All patients underwent objective testing with endoscopy and/or ambulatory reflux monitoring and were categorized as proven GERD (GER+) or no proven GERD (GER-).

KEY RESULTS

One hundred twenty-nine patients were included: 66% female, mean age 54.1 (17.5) years, mean BMI 27.6 (6.8) kg/m, 66% Caucasian, 57% with an elevated LCAT, and 53% GER+. Moderate-to-severe anxiety was found in 39% and moderate-to-severe depression in 19%. An elevated LCAT alone or with an elevated anxiety/depression score was found in 58%. Patient-reported outcomes scores, including LCAT scores (32.9 (13.8) GER- vs. 33.1 (12.6) GER+, p = 0.91), were similar between patients with and without GER+.

CONCLUSIONS AND INFERENCES

Patients with chronic LPS experience heightened levels of hypervigilance, symptom-specific anxiety, and psychosocial distress, regardless of the presence of pathologic GER.

摘要

背景

患有慢性咽喉症状的患者,无论是否存在病理性反流,对标准治疗的反应往往较差,这可能是由于重叠的认知-情感过程所致。因此,本研究的目的包括测量慢性咽喉症状(LPS)患者的心理社会困扰和咽喉特异性认知困扰,并比较有和无明确胃食管反流病(GERD)的咽喉症状患者之间的这些情况。

方法

这项前瞻性、单中心研究纳入了 9 月 22 日至 6 月 23 日期间患有慢性 LPS 的成年人。患者完成了八项关于生活质量、症状负担和心理社会困扰的问卷。咽喉认知情感工具(LCAT)评估咽喉特异性警觉性和焦虑;LCAT 评分≥33 为升高。所有患者均接受了内镜和/或动态反流监测的客观检查,并分为有明确 GERD(GER+)或无明确 GERD(GER-)。

主要结果

共纳入 129 例患者:女性占 66%,平均年龄 54.1(17.5)岁,平均 BMI 27.6(6.8)kg/m,66%为白种人,57%的 LCAT 升高,53%的 GER+。发现 39%存在中度至重度焦虑,19%存在中度至重度抑郁。单独或伴有焦虑/抑郁评分升高的 LCAT 升高见于 58%的患者。患者报告的结局评分,包括 LCAT 评分(GER-为 32.9(13.8),GER+为 33.1(12.6),p=0.91),在有和无 GERD 的患者之间相似。

结论

患有慢性 LPS 的患者经历了更高水平的警觉性、症状特异性焦虑和心理社会困扰,无论是否存在病理性 GER。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9820/11321921/0200bbb6526c/nihms-2003712-f0002.jpg

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本文引用的文献

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