A comparison of pH＜4 and pH＜ 5 as thresholds for 24-hour pH monitoring in the diagnosis of laryngopharyngeal reflux

作者：Wang Jiasen; Li Jinrang

来源：中华耳鼻咽喉头颈外科杂志, 2016, 51(9).

DOI：10.3760/cma.j.issn.1673-0860.2016.09.005

• Laryngopharyngeal reflux
• Esophageal pH monitoring
• Signs and symptoms

Objective To evaluate the consistency between 24-hour pH monitoring,reflux symptom index(RSI) and reflux finding score(RFS) when using pH ＜4 or pH ＜5 as threshold for 24-hour pH monitoring in the diagnosis of laryngopharyngeal reflux.Methods Patients who presented with suspicious laryngopharyngeal reflux between February 2014 and December 2015 were included in this study.pH ＜4 and pH ＜ 5 reflux episodes,PSI and RFS were collected.The consistency between 24-hour pH monitoring and scale results were analyzed when pH ＜ 4 or pH ＜ 5 as threshold respectively.The sensitivity and specificity of 24-hour pH monitoring were calculated separately.Results Median number (M [P25,P75,P95]) of reflux events were 0 [0,3.0,5.5] when using pH ＜4 as pathological threshold and 0 [0,4.0,and 8.5] using pH ＜ 5 as pathological threshold.Laryngopharyngeal reflux was determined in 34.5％ patients depending on 24-hour pH monitoring when pH ＜ 4 was used as threshold,chi-square revealed medium consistency (K =0.483) between pH monitoring and scale result.If pH ＜ 5 was used as threshold,41.8％ patients were detected with laryngopharyngeal reflux,and the consistency of pH monitoring and scale result was medium (κ =0.540).With PSI and RFS for reference,the sensitivity and specificity of 24-hour pH monitoring were 54.7％ and 93.4％ respectively when pH ＜4 was used as threshold.If pH ＜5 was used as threshold,the sensitivity and specificity of 24-hour pH monitoring were 65.6％ and 91.3％ respectively.Conclusions Compared with pH ＜4 as pathological threshold,the consistency of pH monitoring and scale results was a little better using pH ＜ 5 as pathological threshohl.

• 单位
  北京; 中国人民解放军海军总医院