目的:喉咽反流(LPR)与良性声带病变(BVFL)的形成之间存在联系。然而,以前的研究主要集中在症状和体征提示的LPR,而不是通过咽部pH监测客观诊断LPR。我们,因此,进行了一项荟萃分析,以评估咽部pH监测诊断的LPR与BVFL几率之间的关系。
方法:通过搜索PubMed,Embase,科克伦图书馆,和WebofScience。
方法:我们使用CochraneQ检验评估研究之间的异质性,并估计I2统计量。当观察到显著的异质性时,使用随机效应模型;否则,使用固定效应模型。
结果:纳入了9项研究的13个数据集。其中,493例诊断为LPR,344例诊断为BVFL。LPR与BVFL的较高几率相关(优势比:3.26,95%置信区间:1.84-5.76,P<.001),具有中等异质性(CochraneQ检验的P=.006,I2=57%)。亚组分析表明,在仅使用咽部pH监测(Restech)的研究中,这种关联相似。双探针或3位pH监测,并进行24小时多通道腔内阻抗-pH监测(亚组差异P=.15)。此外,亚组分析显示,亚洲和欧洲的研究结果一致(亚组分析P=.12),这种关联似乎与莱因克的声带水肿一致,结节,和息肉(亚组差异P=.09)。
结论:咽部pH监测诊断为LPR与BVFL的形成有关。
OBJECTIVE: There is a link between laryngopharyngeal reflux (LPR) and the formation of benign vocal fold lesions (BVFLs). However, previous studies have mainly focused on LPR suggested by symptoms and signs, rather than objectively diagnosed LPR via pharyngeal pH monitoring. We, therefore, conducted a Meta-analysis to evaluate the association between pharyngeal pH monitoring diagnosed LPR and the odds of BVFLs.
METHODS: Relevant observational studies were identified by searching PubMed, Embase, Cochrane Library, and Web of Science.
METHODS: We evaluated between-study heterogeneity using the Cochrane Q test and estimated the I2 statistic. Random-effects models were used when significant heterogeneity was observed; otherwise, fixed-effects models were used.
RESULTS: Thirteen datasets from 9 studies were included. Among them, 493 were diagnosed with LPR and 344 had BVFLs. LPR was related to a higher odds of BVFLs (odds ratio: 3.26, 95% confidence interval: 1.84-5.76, P < .001) with moderate heterogeneity (P for Cochrane Q test = .006, I2 = 57%). Subgroup analyses showed that the association was similar in studies with only pharyngeal pH monitoring (Restech), with double-probe or 3-site pH monitoring, and with 24-hour multichannel intraluminal impedance-pH monitoring (P for subgroup difference = .15). In addition, subgroup analysis showed consistent results in studies from Asia and Europe (P for subgroup analysis = .12), and the association seemed to be consistent for vocal Reinke\'s edema, nodules, and polyps (P for subgroup difference = .09).
CONCLUSIONS: Pharyngeal pH monitoring diagnosed LPR is associated with the formation of BVFLs.