Clinical Significance Of Laryngopharyngeal Reflux In Patients With Chronic Obstructive Pulmonary Disease

Objective:This research mainly assessed the prevalence of laryngopharyngeal reflux disease(LPRD)and its associated risk factors in patients with chronic obstructive pulmonary disease(COPD).Methods:During the period from January 2016 to December 2016,in the management of chronic respiratory disease of respiratory medicine management center of Ningbo Yinzhou people's Hospital of chronic obstructive pulmonary disease patients,we collected demographic data of the patient,past medical history,and drug treatment in the past year,patients with reflux symptom index(RSI),reflux finding score(RFS),modified british medical research council(mMRC).Recorded the patient's lung function examination,24 hours pharyngeal pH monitoring and other data.To compare the prevalence and risk factors of laryngeal reflux disease in stable and acute exacerbations of chronic obstructive pulmonary disease.At the same time,the correlation between the treatment of chronic obstructive pulmonary disease and the incidence of laryngopharyngeal reflux was analyzed.Results:This research included 72 patients,including 40 cases of male(55.6%),32 cases of female(44.4%),the mean age of the patients(mean ± SD)was 54.9±16.9 years,who were excluded from the group according to the exclusion criteria According to its clinical stage,it was divided into acute exacerbation in 34 cases(47.2%)and stable stage in 38 cases(52.8%).In the final,13 patients(18.1%)had a positive Ryan score.The positive rate of patients with acute recombination was 29.4%(10/34),and the positive rate of patients in the stable group was 7.9%(3/38).The combination OR value of LPR risk factors and 95%CI were: chronic obstructive pulmonary disease severity(C+D group)(OR = 1.52,95%CI:1.47~1.57)The drugs include oral glucocorticoids(OR=1.36,95%CI:1.32~1.41),short acting ?2agonist(OR=1.11,95%CI: 0.74~1.65),inhalation of glucocorticoid combined with short acting ?2 agonist(OR=1.51,95%CI: 1.41~1.59),theophyllinum(OR=1.19,95%CI: 1.07~1.24).Conclusion:The prevalence of laryngopharyngeal reflux disease in patients with chronic obstructive pulmonary disease is higher.It is also a common risk factor for acute exacerbation of chronic obstructive pulmonary disease.Therefore,it is necessary to attract the attention of the clinicians.However,the clinical manifestations of patients are often varied and lack of characteristic,and it is very difficult to diagnose the disease based on symptoms and signs.At present,24 hours pH monitoring is the best method to diagnose the disease.However,diagnosis of the disease based on the Ryan index may lead to missed diagnosis of some patients.Further studies are still needed to determine the optimal threshold for the diagnosis of reflux disease in the patients with chronic obstructive pulmonary disease.