中国耳鼻咽喉头颈外科
中國耳鼻嚥喉頭頸外科
중국이비인후두경외과
Chinese Archives of Otolaryngology-Head and Neck Surgery
2015年
9期
445-448
,共4页
刘凡理%陈波蓓%陈小燕%倪丽艳
劉凡理%陳波蓓%陳小燕%倪麗豔
류범리%진파배%진소연%예려염
胃食管反流%治疗%咽喉反流性疾病%质子泵抑制剂%食管动力学
胃食管反流%治療%嚥喉反流性疾病%質子泵抑製劑%食管動力學
위식관반류%치료%인후반류성질병%질자빙억제제%식관동역학
Gastroesophageal Reflux%THERAPY%laryngopharyngeal reflux disease%proton pump inhibitor%esophageal motility
目的通过埃索美拉唑联合伊托必利诊断性治疗，观察咽喉反流性疾病（laryngopharyngeal reflux disease，LPRD）患者在治疗前后反流症状体征的变化及食管动力学特点。方法将疑似LPRD患者进行诊断性治疗，治疗前后均行反流体征评分量表（reflux finding score， RFS）和反流症状指数量表（reflux symptom index，RSI）的评分及高分辨率食管测压（high resolusion manometry， HRM）检测。按胃食管反流病（gastroesophageal reflux disease，GERD）问卷评分标准，分为单纯LPRD组和LPRD伴GERD组。结果确诊为LPRD患者38例，单纯LPRD组12例，LPRD伴GERD组26例。两组中患者年龄、性别构成比、BMI等差异均无统计学意义。单纯LPRD组RSI评分在治疗前后差异有统计学意义（Z=-3.009，P＜0.05），RFS评分在治疗前后差异无统计学意义（Z=-0.976，P＞0.05）， LPRD伴GERD组RSI和RFS评分在治疗前后差异均有统计学意义（P＜0.05）。单纯LPRD组治疗前后食管动力变化差异无统计学意义，LPRD伴GERD组食管动力参数UESP、LESP、DCI和DL在治疗前后的变化均有统计学意义。结论单纯LPRD患者反流体征较症状的明显改善需要更长的治疗时间。埃索美拉唑联合伊托必利能改善LPRD伴GERD的食管动力，单纯的LPRD治疗前后食管动力无明显变化，一定程度上提示了单纯LPRD与GERD存在不同的发病机制。
目的通過埃索美拉唑聯閤伊託必利診斷性治療，觀察嚥喉反流性疾病（laryngopharyngeal reflux disease，LPRD）患者在治療前後反流癥狀體徵的變化及食管動力學特點。方法將疑似LPRD患者進行診斷性治療，治療前後均行反流體徵評分量錶（reflux finding score， RFS）和反流癥狀指數量錶（reflux symptom index，RSI）的評分及高分辨率食管測壓（high resolusion manometry， HRM）檢測。按胃食管反流病（gastroesophageal reflux disease，GERD）問捲評分標準，分為單純LPRD組和LPRD伴GERD組。結果確診為LPRD患者38例，單純LPRD組12例，LPRD伴GERD組26例。兩組中患者年齡、性彆構成比、BMI等差異均無統計學意義。單純LPRD組RSI評分在治療前後差異有統計學意義（Z=-3.009，P＜0.05），RFS評分在治療前後差異無統計學意義（Z=-0.976，P＞0.05）， LPRD伴GERD組RSI和RFS評分在治療前後差異均有統計學意義（P＜0.05）。單純LPRD組治療前後食管動力變化差異無統計學意義，LPRD伴GERD組食管動力參數UESP、LESP、DCI和DL在治療前後的變化均有統計學意義。結論單純LPRD患者反流體徵較癥狀的明顯改善需要更長的治療時間。埃索美拉唑聯閤伊託必利能改善LPRD伴GERD的食管動力，單純的LPRD治療前後食管動力無明顯變化，一定程度上提示瞭單純LPRD與GERD存在不同的髮病機製。
목적통과애색미랍서연합이탁필리진단성치료，관찰인후반류성질병（laryngopharyngeal reflux disease，LPRD）환자재치료전후반류증상체정적변화급식관동역학특점。방법장의사LPRD환자진행진단성치료，치료전후균행반류체정평분량표（reflux finding score， RFS）화반류증상지수량표（reflux symptom index，RSI）적평분급고분변솔식관측압（high resolusion manometry， HRM）검측。안위식관반류병（gastroesophageal reflux disease，GERD）문권평분표준，분위단순LPRD조화LPRD반GERD조。결과학진위LPRD환자38례，단순LPRD조12례，LPRD반GERD조26례。량조중환자년령、성별구성비、BMI등차이균무통계학의의。단순LPRD조RSI평분재치료전후차이유통계학의의（Z=-3.009，P＜0.05），RFS평분재치료전후차이무통계학의의（Z=-0.976，P＞0.05）， LPRD반GERD조RSI화RFS평분재치료전후차이균유통계학의의（P＜0.05）。단순LPRD조치료전후식관동력변화차이무통계학의의，LPRD반GERD조식관동력삼수UESP、LESP、DCI화DL재치료전후적변화균유통계학의의。결론단순LPRD환자반류체정교증상적명현개선수요경장적치료시간。애색미랍서연합이탁필리능개선LPRD반GERD적식관동력，단순적LPRD치료전후식관동력무명현변화，일정정도상제시료단순LPRD여GERD존재불동적발병궤제。
[ABSTRACT]OBJECTIVETo study the changes of symptoms, signs and esophageal dynamics characteristics of laryngopharyngeal reflux diseases(LPRD) before and after treatment with esomeprazole and itopride.METHODS The suspected LPRD patients were took the diagnostic treatment with esomeprazole and itopride. Reflux finding score(RFS), reflux symptoms index(RSI) score and high-resolution esophageal pressure were evaluated before and after treatment. The patients were divided into pure LPRD group and LPRD with GERD group according to gastroesophageal reflux disease(GERD) questionnaire scores.RESULTS There were 38 patients confirmed with LPRD(pure LPRD group:12 cases, LPRD with GERD group:26 cases). The BMI, age, gender ratio had no statistical difference between the two groups(P>0.05). In LPRD group, RSI had significant difference before and after treatment(Z=-3.009,P<0.05), but the RFS had no statistical difference before and after treatment(Z=-0.976, P>0.976). In LPRD with GERD group, the RSI and RFS had significant difference before and after treatment(P<0.05). In LPRD group, the esophageal dynamic change had no significant difference before and after treatment(P>0.05), but in LPRD with GERD group, esophageal dynamic parameters of UESP, LESP, DCI, DL had significant difference before and after treatment(P<0.05).CONCLUSIONIn pure LPRD group, the reflux symptoms improved obviously after treatment, but the signs may need treatment for more time. Esomeprazole combined with itopride can improve the esophageal dynamics in LPRD with GERD group, but can not improve that in pure LPRD group. The results suggested that the LPRD and GERD have different pathogenesis.
