伴有幽门螺杆菌感染的咽喉反流患者的反流类型分析

doi:10.6040/j.issn.1673-3770.0.2024.059

摘要/Abstract

摘要： 目的探讨伴有幽门螺旋杆菌(helicobacter pylori, HP)感染的咽喉反流(laryngopharyngeal reflux, LPR)患者的反流类型。方法应用¹⁴C呼气试验和24 h阻抗-pH监测(24 h MII-pH),将所有LPR患者分为HP(+)的LPR患者(实验组)和HP(-)的LPR患者(对照组),实验组和对照组均行电子喉镜检查,并根据反流症状指数量表(reflux symptom index, RSI)、反流体征评分量表(reflux finding score, RFS)进行评分,分析比较实验组和对照组其RSI及RFS评分、反流总次数、酸性反流次数、非酸性反流次数及上述反流类型的差异。结果结合24 h MII-pH监测及¹⁴C呼气试验结果,54例LPR(+)患者中,实验组14例(HP+),对照组40例(HP-),HP感染率25.93%(14/54)。实验组和对照组其RSI(P=0.424>0.05)及RFS(P=0.382>0.05)量表总分及各项症状、体征发生率均无统计学意义(P>0.05),且咽喉部总反流次数(P=0.470>0.05)、酸性反流次数(P=0.207>0.05)及非酸反流次数(P=0.921>0.05),也无统计学意义(P>0.05)。然而,实验组非酸反流比例显著大于酸性反流(57.14% vs. 14.29%,P⁺_Non-acid=0.046),但混合反流和非酸反流、酸性反流之间均无统计学意义(P>0.05);对照组混合反流和非酸反流比例均大于酸性反流(45.00% vs. 15.00%,P^-_Mix=0.003;40.00% vs. 15.00%,P^-_Non-acid=0.012),但混合反流和非酸反流比例无统计学意义(P=0.651)。结论与HP(-)LPR患者相比,HP(+)LPR患者其反流类型以非酸反流为主,咳嗽、假声带沟及喉内黏液附着等症状体征表现更加明显。

关键词: 幽门螺杆菌感染, 咽喉反流, MII-pH监测, 反流类型, 反流症状指数量表, 反流体征评分量表

Abstract: Objective To investigate the reflux types of Laryngopharyngeal reflux(LPR)patients with Helicobacter pylori(HP)infection. Methods According to ¹⁴C breath test and 24-hour impedance pH monitoring(24 h MII-pH), all LPR patients were divided into HP(+)LPR patients(the experimental group)and HP(-)LPR patients(the control group). Both experimental and control patients underwent electronic laryngoscopy and completed reflux symptom index(RSI)and reflux finding score(RFS). The RSI and RFS scores, the number of total reflux, acid reflux and non-acid reflux and the reflux types were analyzed and compared to explore the difference between the experimental group and the control group. Results Combined with the results of 24 h MII-pH monitoring and ¹⁴C breath test, 54 patients were LPR(+), including 14 cases HP(+)(the experimental group)and 40 cases HP(-)(the control group), and the infection rate of HP was 25.93%(14/54). In the experimental group and the control group, there were no significant differences in the total score of the RSI(P=0.424>0.05)and RFS(P=0.382>0.05)scale and the incidence of symptoms and signs(P>0.05), and there were also no significant differences in the total number of reflux(P=0.470>0.05), acid reflux(P=0.207>0.05)and non-acid reflux(P=0.921>0.05)between them(P>0.05). In the experimental group, the proportion of non-acid reflux was significantly higher than that of acid reflux(57.14% vs. 14.29%,P⁺_Non-acid=0.046),while the ratio between mixed reflux and non-acid reflux and the ratio between mixed reflux and acid reflux were both no significant different(P>0.05).In the control group the proportions of mixed reflux and non-acid reflux were significantly higher than those of acid reflux(45.00% vs. 15.00%,P^-_Mix=0.003;40.00% vs. 15.00%,P^-_Non-acid=0.012), but there was no significant difference between mixed reflux and non-acid reflux ratio(P=0.651). Conclusion Compared with the HP(-)LPR patients, the main reflux type of HP(+)LPR patients was non-acid reflux, and the symptoms and signs of cough, subglottic edema and thick endolaryngeal mucus were more obvious.

Key words: Helicobacter pylori infection, Laryngopharyngeal reflux, MII-pH monitoring, Reflux type, RSI, RFS

中图分类号:

R766.5

刘小红,张青青,郭瑞昕,强茵,石瑶,杨皓楠,曹楠,加伟,谢萌. 伴有幽门螺杆菌感染的咽喉反流患者的反流类型分析[J]. 山东大学耳鼻喉眼学报, 2024, 38(6): 108-114.

LIU Xiaohong, ZHANG Qingqing, GUO Ruixin, QIANG Yin, SHI Yao, YANG Haonan, CAO Nan, JIA Wei, XIE Meng. Analysis of reflux types in patients with laryngeal reflux associated with Helicobacter pylori infection[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(6): 108-114.

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