唾液胃蛋白酶检测在反流性咽喉炎诊断中的价值

目的 评估口腔中唾液胃蛋白酶检测对反流性咽喉炎(LPR)患者的诊断价值。 方法 选取25例LPR患者,反流症状指数量表(RSI)>13分,反流体征指数量表(RFS)>7分,治疗前采用蛋白印迹法检测患者唾液胃蛋白酶,之后口服埃索美拉唑肠溶片+2.5%碳酸氢钠雾化吸入治疗2个月,治疗完成后再次行RSI及RFS量表评分并行唾液中胃蛋白酶检测。 结果 治疗前唾液胃蛋白酶检测结果阳性12例,阴性13例。治疗后PPI实验结果阳性10例,阴性15例。唾液胃蛋白酶检测结果与PPI实验结果同为阳性9例,同为阴性12例;PPI实验结果阳性而唾液胃蛋白酶结果阴性1例,PPI实验结果阴性而唾液胃蛋白酶结果阳性3例。以PPI实验阳性作为本研究的诊断标准,胃蛋白酶检测结果诊断LPR的敏感度为90.00%,特异度为80.00%。25例患者均能完成所有检查和治疗,症状得到改善19例,症状未见明显改善6例。治疗前后RSI量表症状评分分别为(19.84±3.96)、(7.00±2.84)分,治疗前后RSI量表症状评分差异有统计学意义(P<0.001)。25例患者体征均得到明显改善,治疗前后RFS量表体征评分分别为(14.08±3.51)、(5.44±3.07)分,治疗前后的RFS量表体征评分差异有统计学意义(P<0.001)。 结论 唾液中胃蛋白酶的检测可用于辅助诊断LPR。

Diagnostic value of detection of pepsin in the saliva for laryngopharyngeal reflux

Objective To determine whether detection of pepsin in the saliva could be useful for diagnosing laryngopharyngeal reflux(LPR). Methods Twenty-five patients having LPR with reflux symptoms index scale(RSI)>13 and a reflux symptoms index scale(RFS)>7 were selected. Pepsin levels were measured by protease-labeling prior to treatment. Patients were treated with esomeprazole along with 2.5% sodium bicarbonate atomization inhalation therapy. Two months after completion of treatment, the RSI, RFS, and pepsin in the saliva were measured again. Results Out of 25, 12 salivary samples were positive and 13 were negative before treatment. PPI test results were positive in 10 cases and negative in 15 cases after treatment. The results of saliva pepsin test and PPI test were both positive in 9 cases and negative in 12 cases. One case had a positive result in the PPI test, and 3 cases had positive results in the salivary pepsin test. The diagnostic criteria for this study included a positive result on PPI test, and a sensitivity and specificity of 90.00% and 80.00%, respectively, in the detection results of pepsin. All 25 patients were able to complete the entire investigation and treatment course. The symptoms improved in 19 cases, while they did not significantly improve in 6 cases. The scores of the RSI scale before and after treatment were 19.84±3.96 and 7.00±2.84 respectively, with the difference being statistically significant(P<0.001). Signs obviously improved in all 25 cases. The RFS scale score before and after treatment was 14.08±3.51 and 5.44±3.07 respectively, with the difference being statistically significant(P<0.001). Conclusion The detection of pepsin in the saliva can be used for the diagnosis of LPR.