喉咽反流疾病的治疗持续时间与临床反应模式
Treatment Duration and Clinical Response Patterns of Laryngopharyngeal Reflux Disease.
文献信息
| PMID | 42779545 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Jerome R Lechien |
| 作者单位 | Department of Surgery, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium. |
| 期刊 | Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery |
| SCI 分区 | Q1 |
| IF | 2.9 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 探讨确诊喉咽反流病（LPRD）患者在治疗持续时间、抵抗及治疗失败方面的治疗反应模式。
研究设计： 前瞻性研究。
地点： 大学医院。
方法： 前瞻性招募有喉咽症状且24小时下咽-食管阻抗-pH监测显示>1次咽部反流事件的患者（欧洲反流诊所，2017年1月至2025年10月）。根据LPRD模式，患者接受饮食/生活方式措施联合藻酸盐、镁铝加合物和/或PPI，以连续3个月疗程治疗，直至症状显著缓解允许停药。评估结局（RSS、RSA）、最佳治疗持续时间、成功/减量率及慢性化。
结果： 共361例连续患者完成评估（女性214例，59.3%），其中135例（37.4%）、87例（24.1%）和139例（38.5%）分别表现为轻度、中度和重度反流疾病（IFOS分类）。在304例完成随访的患者中，105例（34.5%）达到完全缓解，主要发生在治疗后6周（27.6%）、3个月（42.9%）和6个月（21.9%）；93/105例（88.6%）停药后保持无症状。148/304例（48.7%）患者在继续饮食和生活方式调整伴/不伴药物治疗下症状稳定。尽管更换药物类别，仍有21/304例（6.9%）和30/304例（9.9%）出现波动性缓解和慢性病程。二元logistic回归显示基线IFOS分类是完全缓解的显著预测因素（P = .038，OR = 1.518，95% CI [1.024-2.251]）。
结论： 识别出几种LPRD模式：34.5%达到完全缓解，48.7%显示持续症状减轻，16.8%尽管更换药物类别仍有波动性/慢性症状。基线IFOS评分预测治疗轨迹和结局。
英文摘要
OBJECTIVE: To investigate the therapeutic response patterns in terms of duration, resistance, and therapeutic failure in patients with a confirmed LPRD diagnosis.
STUDY DESIGN: Prospective study.
SETTING: University hospital.
METHODS: Patients with laryngopharyngeal symptoms and >1 pharyngeal reflux event on 24-h hypopharyngeal-esophageal impedance-pH monitoring were prospectively recruited (European Reflux Clinic, Jan 2017-Oct 2025). Based on LPRD pattern, they received diet/lifestyle measures plus alginate, magaldrate and/or PPIs in successive 3-month courses until significant symptom relief allowed discontinuation. Outcomes (RSS, RSA) and optimal treatment duration, success/weaning rates, and chronicity were assessed.
RESULTS: A total of 361 consecutive patients completed the evaluations (214 females, 59.3%), with 135 (37.4%), 87 (24.1%), and 139 (38.5%) presenting mild, moderate, and severe reflux disease (IFOS classification), respectively. Of 304 patients with complete follow-up, 105 (34.5%) achieved complete response, occurring primarily at 6 weeks (27.6%), 3 months (42.9%), and 6 months (21.9%) posttreatment; 93/105 (88.6%) remained symptom-free after discontinuation. Symptoms stabilized in 148/304 (48.7%) patients continuing diet and lifestyle modifications with/without medication. Fluctuating relief and chronic course occurred in 21/304 (6.9%) and 30/304 (9.9%) despite drug class changes. Binary logistic regression revealed baseline IFOS classification as a significant predictor of complete response (P = .038, OR = 1.518, 95% CI [1.024-2.251]).
CONCLUSION: Several LPRD patterns were identified: 34.5% achieved complete remission, 48.7% showed sustained symptom reduction, and 16.8% had fluctuating/chronic symptoms despite drug class changes. Baseline IFOS score predicts therapeutic trajectory and outcomes.