目的:研究咽喉反流(LPR)患者和无症状个体唾液中消化酶和生物标志物的变化。
方法:前瞻性对照研究。
方法:多中心研究。
方法:从2020年1月至2023年4月,从2所大学医院连续招募了下咽食管阻抗-pH监测(HEMII-pH)的LPR患者和无症状个体。收集患者(PPIs外)和无症状个体的唾液以测量pH值,弹性蛋白酶,胆汁盐,胆固醇,胃,和胰脂肪酶.焦虑,症状,并通过感知压力量表(PSS)研究了研究结果,反流症状评分(RSS),和反流体征评估(RSA)。
结果:67名LPR患者和57名无症状个体完成了评估。LPR患者报告PSS较高,RSS,和RSA比无症状个体。与对照组(6.13;95%CI:5.95,6.31;P=.001)相比,LPR患者的平均唾液pH更碱性(7.23:95%置信区间[CI]:7.08,7.38)。患者的弹性蛋白酶平均浓度(51.65µg/mL;95%CI:44.47,58.83µg/mL)高于无症状个体(25.18µg/mL;95%CI:21.64,28.72µg/mL;P=.001)。健康个体的唾液胆固醇浓度(3.43mg/dL;95%CI:3.21,3.65mg/dL)高于患者(1.16mg/dL;95%CI:1.05,1.27mg/dL;P=.001)。唾液的pH值,弹性蛋白酶浓度与基线RSS显著相关,而唾液胆固醇与RSS和RSA的严重程度呈负相关。
结论:胆固醇,胆汁盐,和弹性蛋白酶是LPR的生物标志物,应考虑开发未来用于检测LPR的非侵入性唾液装置。
OBJECTIVE: To investigate the digestive enzymes and biomarkers in the saliva of patients with laryngopharyngeal reflux (LPR) and asymptomatic individuals.
METHODS: Prospective controlled
study.
METHODS: Multicenter
study.
METHODS: Patients with LPR at the hypopharyngeal-esophageal impedance-pH monitoring (HEMII-pH) and asymptomatic individuals were consecutively recruited from January 2020 to April 2023 from 2 University Hospitals. The saliva of patients (off PPIs) and asymptomatic individuals was collected to measure pH, elastase, bile salts, cholesterol, gastric, and pancreatic lipases. Anxiety, symptoms, and findings were studied through perceived stress scale (PSS), reflux symptom score (RSS), and reflux sign assessment (RSA).
RESULTS: Sixty-seven LPR patients and 57 asymptomatic individuals completed the evaluations. LPR patients reported higher PSS, RSS, and RSA than asymptomatic individuals. The mean saliva pH was more alkaline in LPR patients (7.23: 95% confidence interval [CI]: 7.08, 7.38) compared to controls (6.13; 95% CI: 5.95, 6.31; P = .001). The mean concentration of elastase was higher in patients (51.65 µg/mL; 95% CI: 44.47, 58.83 µg/mL) versus asymptomatic individuals (25.18 µg/mL; 95% CI: 21.64, 28.72 µg/mL; P = .001). The saliva cholesterol reported higher concentration in healthy individuals (3.43 mg/dL; 95% CI: 3.21, 3.65 mg/dL) compared to patients (1.16 mg/dL; 95% CI: 1.05, 1.27 mg/dL; P = .001). The saliva pH, and elastase concentration were significantly associated with the baseline RSS, while saliva cholesterol was negatively associated with the severity of RSS and RSA.
CONCLUSIONS: Cholesterol, bile salts, and elastase are biomarkers of LPR and should be considered to develop future non-invasive saliva device for the detection of LPR.