妊娠期女性咽喉反流症状指数调查及影响因素分析

doi:10.6040/j.issn.1673-3770.0.2024.046

摘要/Abstract

摘要： 目的探讨妊娠期女性咽喉反流情况,并分析影响因素。方法前瞻性收集2020年1月至2023年10月就诊的妊娠期女性病历资料,并对其每次产检时进行反流症状指数量表(reflux symptom index, RSI)调查,记录年龄、身高,以及相应孕周体质量、体质量指数(Body Mass Index, BMI)、子宫长度、腹围等临床资料,进行统计分析。结果本研究共纳入150例有效受访者,有效调查问卷150组共1 350份,其中RSI>13分的问卷381份。22~46岁,平均(29.66±4.971)岁;身高153~175 cm,平均(163.0±5.005)cm;入组时体质量43~86 kg,平均(58.83±8.924)kg,入组时BMI(16.18~29.76),平均(22.12±2.908),分娩时孕周(35+4)周~(41+6)周,分娩时体质量55~124 kg,平均(76.19±12.52)kg,分娩时BMI(20.70~42.41),平均(28.63±4.380),随着孕周增长,受访者体质量、BMI、RSI逐渐增大,RSI阳性率孕早期19.33%,孕中期33.33%,孕晚期66.67%,差异有统计学意义(P<0.05)。单因素分析以孕周、年龄、身高、BMI、腹围分别对妊娠期女性RSI 9次调查RSI>13影响进行单因素分析,其中孕周比较差异有统计学意义(P<0.05),其余因素差异无统计学意义(P>0.05);孕中晚期在孕周、年龄、身高、BMI、子宫长度、腹围分别对孕中晚期RSI>13影响进行单因素分析,其中孕周、BMI、子宫长度、腹围进行比较差异有统计学意义(P<0.05),年龄、身高比较差异无统计学意义(P>0.05)。多因素Logistic回归分析将孕周、BMI、子宫长度、腹围等4项因素分析,结果显示BMI、腹围对RSI>13的影响差异有统计学意义(P<0.05),是影响妊娠期女性中晚期RSI>13的独立危险因素;孕中晚期BMI指数与RSI>13的ROC分析,AUC=0.922,截断值27.265,腹围与RSI>13的ROC分析,AUC=0.896,截断值88.5,差异均有统计学意义(P<0.001)。结论妊娠期女性在孕期随着BMI、腹围的增加,RSI>13比例升高,BMI和腹围可以作为产科医生评估妊娠期女性是否患有LPRD风险的重要指标。

关键词: 咽喉反流, 反流症状指数量表, 妊娠期女性, 体质量指数, 腹围

Abstract: Objective To explore the throat reflux in women in the course of pregnancy and analyze the influencing factors. Methods The medical records of pregnant women from January 2020 to October 2023 were prospectively collected, and the number of reflux symptoms, age, height, and corresponding gestational weight, body mass index, uterine length, and abdominal circumference were recorded for statistical analysis. Results This study included 150 valid respondents and 1350 valid questionnaires from 150 groups, including 381 questionnaires with RSI>13 points. From 22 to 46 years old, Mean(29.66±4.971)years; 153 to 175 cm, Mean(163.0±5.005)cm; Body mass of 43 to 86 kg when enrollment, Mean(58.83±8.924)kg, BMI(16.18-29.76), average(22.12±2.908), from(35⁺⁴)weeks to(41⁺⁶)weeks at delivery, Body mass 55 to 124 kg, mean(76.19±12.52)kg, BMI(20.70 to 42.41), Average(28.63±4.380). As the gestational age increases, Gradually increase increased body mass, BMI, RSI. RSI positive rate in early pregnancy was 19.33%, second trimester 33.33%, Late pregnancy trimester 66.67%, The difference was statistically significant(P<0.05). Univariate analysis of the influence of RSI, RSI, 13 by gestational age, age, height, BMI and abdominal circumference, where the gestational week comparison difference was statistically significant(P<0.05). The other factors were not significant(P>0.05). Univariate analysis of the effects of gestational age, age, height, BMI, uterine length, and abdominal circumference on RSI>13 in the middle and late trimester. Among them, gestational age, BMI, uterine length and abdominal circumference were significantly different(P<0.05), There was no significant difference between age and height(P>0.05).In multivariate Logistic regression analysis, four factors including gestational age, BMI, uterine length, and abdominal circumference showed that BMI and abdominal circumference on RSI>13(P<0.05), an independent risk factor for RSI>13, ROC for AUC=0.922, 27.265, ROC for abdominal circumference and RSI>13, AUC=0.896, 88.5, were statistically significant(P<0.001). Conclusion With the increase of BMI and abdominal circumference during pregnancy, the proportion of RSI>13 increased,BMI and abdominal circumference can be used as important indicators for obstetricians to assess whether pregnant women are at risk of LPRD.

Key words: Laryngopharyngeal reflux, Reflux symptom index, Pregnant women, Body mass index, Circumference of abdomen

中图分类号:

R766.5

魏鑫,邢东升,翟振伟,阎艾慧,刘振宇,曹弘薇. 妊娠期女性咽喉反流症状指数调查及影响因素分析[J]. 山东大学耳鼻喉眼学报, 2024, 38(6): 96-102.

WEI Xin, XING Dongsheng, ZHAI Zhenwei, YAN Aihui, LIU Zhenyu, CAO Hongwei. Study of the laryngeal reflux symptom index and analysis of influencing factors in pregnant women[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(6): 96-102.

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