An epidemiological survey of laryngopharyngeal refux disease in otorhinolaryngology head and neck surgery clinics in Chongqing area
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摘要: 目的 探讨重庆地区耳鼻咽喉头颈外科门诊患者咽喉反流性疾病(LPRD)的患病情况及影响因素, 为该病的临床诊断和治疗提供依据。方法 采用多中心横断面调查及系统抽样的方法, 对2019年8月至11月重庆地区十五家医院耳鼻咽喉头颈外科门诊患者进行反流症状指数评分量表(RSI)评估, 同时收集相关饮食习惯并分析其影响因素。结果 有效问卷3234份, 阳性385例, LPRD构成比为11.90%(385/3234), 其中男性与女性构成比分别为12.55%(173/1378)和11.42%(212/1856), 男性高于女性, 差异有统计学意义(P < 0.05)。不同年龄段之间构成比差异有统计学意义(P < 0.05), 其中40~59岁年龄段构成比最高, 为12.23%(170/1390)。咽部异物感(症状8)和持续清嗓(症状2)与RSI得分相关性最大, 饭后或躺下后咳嗽(症状5)和烦人的咳嗽(症状7)在LPRD中常同时存在。Logistic回归分析结果显示饮食辛辣、进食过饱及吸烟与LPRD密切相关。结论 咽部异物感和持续清嗓在LPRD中最常见。饮食辛辣、进食过饱及吸烟增加了LPRD患病的风险, 是LPRD的危险因素。Abstract: Objective To investigate the prevalence and affecting factors of laryngopharyngeal reflux disease(LPRD) in otolaryngology head and neck surgery in Chongqing, and to provide a basis for the clinical diagnosis and therapy of LPRD.Methods Multi-center cross-sectional survey method and systematic sampling method were used to select patients at fifteen hospitals in Chongqing from August to November in 2019. Then reflux symptom index(RSI) was investigated. At the same time, the information of the relevant dietary habits, including smoking and drinking, spicy diet, high-fat diet, and satiety was collected. Moreover, the factors related to LRPD(gender, age, symptoms, diet and lifestyle) were analyzed.Results The composition ratio of LPRD was 11.90%(385/3234) in 3234 effective questionnaires and 385 positive ones. The composition ratio was 12.55%(173/1378) in men and 11.42%(212/1856) in women. The difference between the two groups was statistically significant(P < 0.05). The difference in composition ratio among different age groups was statistically significant(P < 0.05), with the highest composition ratio between 40 and 59 years old(170/1390). Constant throat-clearing(symptom 2) and globus sensation(symptom 8) were most correlated with LPRD. Logistic regression analysis showed that spicy diet, over eating, and smoking were highly related to LPRD.Conclusion Globus sensation and constant throat-clearing are the most common symptoms in LPRD patients. Spicy diet, over eating, and smoking are risk factors for LPRD.
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Key words:
- laryngopharyngeal reflux disease /
- reflux symptom index /
- epidemiology
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表 1 各年龄段性别之间阳性率比较
年龄/岁 男性 女性 合计 调查人数 阳性人数 患病率/% 调查人数 阳性人数 患病率/% 调查人数 阳性人数 患病率/% 19~39 561 73 13.01 651 71 10.91 1212 144 11.88 40~59 542 64 11.81 848 106 12.50 1390 170 12.23 60~79 253 34 13.44 334 34 10.18 587 68 11.58 80~100 22 2 9.09 23 1 4.35 45 3 6.67 合计 1378 173 12.55 1856 212 11.42 3234 385 11.90 
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表 2 饮食生活习惯与LPRD的关系
饮食及生活习惯 阳性组(385例) 阴性组(2849例) 单因素Logistic回归 多因素Logistic回归 OR 95%CI OR 95%CI 饮酒 54(14.03) 261(9.16) 1.26 0.83~2.23 1.07 0.75~1.87 辛辣饮食 209(54.29) 968(33.98) 3.26 2.43~3.13 2.83 1.96~2.84 进食过饱 88(22.86) 223(7.83) 1.81 1.47~2.41 1.65 1.13~1.96 高脂饮食 76(19.74) 470(16.50) 1.17 0.91~1.52 1.14 0.82~1.43 吸烟 78(20.26) 449(15.76) 1.72 0.96~2.39 1.56 0.82~2.11
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表 3 RSI量表各症状评分人数占总人数百分比情况
% 评分 症状1 症状2 症状3 症状4 症状5 症状6 症状7 症状8 症状9 0 74.40 54.11 56.15 82.00 80.61 75.36 77.95 47.16 72.79 1 9.31 16.33 16.11 7.23 9.00 8.78 9.15 11.93 10.48 2 6.93 14.44 12.77 5.81 5.72 7.51 5.69 16.14 8.53 3 4.95 9.40 8.29 3.00 2.75 3.90 3.77 13.30 4.73 4 2.75 4.36 4.61 1.18 1.21 3.09 2.07 7.45 2.20 5 16.70 1.36 2.35 0.77 0.71 1.36 1.36 4.02 1.27
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表 4 RSI各症状双变量相关性分析
变量 症状1 症状2 症状3 症状4 症状5 症状6 症状7 症状8 症状9 RSI 症状1 1 症状2 0.279 1 症状3 0.169 0.328 1 症状4 0.166 0.155 0.152 1 症状5 0.211 0.270 0.278 0.238 1 症状6 0.124 0.196 0.239 0.173 0.197 1 症状7 0.182 0.335 0.275 0.176 0.479 0.201 1 症状8 0.210 0.395 0.288 0.291 0.216 0.149 0.263 1 症状9 0.162 0.197 0.164 0.217 0.162 0.204 0.161 0.236 1 RSI 0.460 0.639 0.594 0.411 0.418 0.445 0.508 0.688 0.433 1
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