摘要
目的探讨唾液胃蛋白酶检测在咽喉反流(LPR)诊断及疗效评估中的应用价值。方法选取2020年6月至2021年6月就诊于福建中医院大学附属第二人民医院耳鼻喉科门诊的116例咽喉不适患者为研究对象。所有患者均接受8周的质子泵抑制剂(PPI)诊断性治疗,治疗前后均接受症状体征评估[采用反流症状指数量表(RSI)与反流体征量表(RFS)评估]与唾液胃蛋白酶检测,最终有67例患者完成治疗。根据RSI与RFS评分进行疗效评估,治疗有效的46例患者纳入LPR组,治疗无效的21例患者纳入慢性咽喉炎组,比较唾液胃蛋白酶阳性率,唾液胃蛋白酶检测LPR的效能及与PPI诊断性治疗结果的一致性,以及两组治疗前后的RSI评分、RFS评分、唾液胃蛋白酶水平。结果LPR组的唾液胃蛋白酶阳性率高于慢性咽喉炎组,差异有统计学意义(P<0.05);唾液胃蛋白酶检测诊断LPR的灵敏度为93.5%,特异度为71.4%,阳性预测值为87.8%,阴性预测值为83.3%;唾液胃蛋白酶检测结果与PPI诊断性治疗结果的一致性好(Kappa=0.675)。治疗前,LPR组RSI评分、RFS评分、唾液胃蛋白酶水平均高于慢性咽炎组,差异均有统计学意义(P<0.05);治疗后,LPR组RSI评分、RFS评分、唾液胃蛋白酶水平均低于治疗前,差异均有统计学意义(P<0.05);但治疗后LPR组RFS评分和唾液胃蛋白酶水平仍高于慢性咽喉炎组,差异有统计学意义(P<0.05)。结论唾液胃蛋白酶检测对LPR具有较高的诊断价值,对疗效评估具有一定的意义,可为该病的诊断及疗效评估提供指导。
Objective Explore the clinical value of salivary pepsin detection in differential diagnosis and evaluation of therapeutic effect of laryngopharyngeal reflux.Methods This study selected 116 patients who were hospitalized in the otorhinolaryngology clinic of The Secend Affiliated Hospital of Fujian University of Traditional Chinese Medicine from June 2020 to June 2021 due to persistent throat symptoms such as dry throat,foreign body sensation in the throat,frequent throat clearing,chronic cough,hoarseness,etc.All patients received diagnostic treatment for 8 weeks.Finally,67 patients completed the evaluation of reflux symptom index(RSI)and reflux Syndrome Scale(RFS)before and after treatment,and the concentration of Salivary Pepsin was measured before and after treatment.According to the therapeutic effect,67 patients were divided into chronic pharyngitis group and pharyngeal reflux group.The concentration and positive rate of salivary pepsin were compared between the two groups;Evaluate the clinical value of salivary pepsin in the diagnosis of laryngopharyngeal reflux with PPI diagnostic treatment test as the standard.Results The positive rate and concentration of salivary pepsin in the two groups were significantly different,The throat reflux group was significantly higher than the chronic pharyngitis group(P<0.05);Salivary pepsin for the diagnosis of laryngopharyngeal reflux has good consistency with the diagnosis of PPI diagnostic treatment test(P<0.05).Compared with before treatment,the concentration of salivary pepsin in the pharyngeal reflux group decreased significantly(P<0.05).Conclusion The detection of salivary pepsin has high diagnostic value for pharyngeal reflux,it has certain significance for efficacy evaluation,so it can provide guidance for the treatment of disease and the judgment of curative effect,and it is worth actively promoting in clinical practice.
作者
徐丛荣
王薇
林琼花
王清泰
杨秋燕
Xu Congrong;Wang Wei;Lin Qionghua;Wang Qingtai;Yang Qiuyan(The Secend Affiliated Hospital of Fujian University of Traditional Chinese Medicine,Fuzhou Fujian 350003,China)
出处
《医疗装备》
2022年第22期17-20,共4页
Medical Equipment
