Shaker R, Milbrath M, Ren J, Toohill R, Hogan W J, Li Q, Hofmann C L
Medical College of Wisconsin Dysphagia Institute, Department of Medicine, Milwaukee, USA.
Gastroenterology. 1995 Nov;109(5):1575-82. doi: 10.1016/0016-5085(95)90646-0.
BACKGROUND & AIMS: A variety of otolaryngological abnormalities have been attributed to the contact of gastroesophageal refluxate with respective structures of the aerodigestive tract. The aim of this study was to determine and compare the pharyngoesophageal distribution of gastric acid refluxate between patients with proven laryngitis attributed clinically to gastroesophageal reflux and three control groups.
An ambulatory 24-hour simultaneous three-site pharyngoesophageal pH monitoring technique was used to measure reflux parameters in the pharynx, proximal esophagus, and distal esophagus.
Between-group comparison showed no significant difference in the reflux parameters in the distal esophagus between the studied groups. A significantly higher percentage of distal reflux episodes reached the proximal esophagus in the laryngitis group than in the control groups (P < 0.01), and the number of pharyngeal reflux episodes and time of acid exposure were significantly higher in the laryngitis group than in the control groups (P < 0.001).
Compared with normal controls and patients with gastroesophageal reflux disease, pharyngeal reflux of gastric acid is significantly more prevalent and the ratio of proximal to distal esophageal acid reflux episodes is significantly increased in patients with posterior laryngitis. Simultaneous three-site ambulatory pharyngoesophageal pH monitoring may provide supporting evidence when the diagnosis of reflux-induced aerodigestive tract lesions is considered.
多种耳鼻喉科异常情况被认为与胃食管反流物接触上消化道相应结构有关。本研究旨在确定并比较临床上确诊为胃食管反流所致喉炎患者与三个对照组之间胃酸反流物在咽喉食管的分布情况。
采用动态24小时同步三部位咽喉食管pH监测技术，测量咽喉、食管近端和食管远端的反流参数。
组间比较显示，研究组之间食管远端的反流参数无显著差异。喉炎组远端反流发作到达食管近端的百分比显著高于对照组（P < 0.01），且喉炎组咽喉反流发作次数和酸暴露时间显著高于对照组（P < 0.001）。
与正常对照组和胃食管反流病患者相比，后喉炎患者胃酸的咽喉反流明显更普遍，且食管近端与远端酸反流发作的比例显著增加。当考虑诊断反流性上消化道病变时，同步三部位动态咽喉食管pH监测可能提供支持证据。
