Objective: To obtain the prevalence laryngopharyngeal reflux disease (LPRD), anxiety and depression in otorhinolaryngology outpatients and to explore the role of mental and psychological factors (anxiety and depression) in their pathogenesis. Methods: A questionnaire survey of reflux symptom index(RSI) scale and hospital anxiety and depression (HAD) scale were used to report 1 111 cases of outpatients in Department of Otorhinolaryngology Head and Neck Surgery, Peking University People's Hospital, from July 2017 to June 2018 (486 males, 625 females, age of 18-96 years old, median age of 38[30,53] years old) and to obtain the prevalence of LPRD, anxiety and depression. RSI-positive patients were selected in the case group, and RSI-negative patients were selected in the control group. The differences in HAD scores between the two groups were compared, and the risk factors of laryngopharyngeal reflux were analyzed. Statistical analysis was performed using SPSS 20.0 software. Results: There were 151 cases in the case group and 960 cases in the control group. The prevalence of LPRD was 13.59% (151/1 111).There was no significant difference in the prevalence of LPRD between different genders (P>0.05). The prevalence rate was the highest in the 18-40 age group, and the difference in the prevalence of all age groups (18~ 40 years old; 41-65 years old; >65 years old) was statistically significant (P<0.05). The prevalence of LPRD among smokers and non-drinkers was higher than that of non-smokers and non-drinkers and the prevalence of the two groups was statistically significant (P<0.05). The most common symptoms of the RSI scale were pharyngeal foreign body sensation (92.72%,140/151), persistent clearing throat (88.74%,124/151), excessive sputum or nasal reflux (82.12%, 124/151). There were significant statistical differences between the two groups (P<0.05). Ninty-one patients with anxiety, the prevalence was 8.19%(91/1 111); 76 patients with depression, the prevalence was 6.84%(76/1 111).Among the LPRD patients, the hospital anxiety scale scored 29.14% (44/151), and the hospital depression scale scored 17.22% (26/151). The scores of anxiety symptoms and depressive symptoms in the LPRD group were higher than those in the non-LPRD group. The above scores were statistically significant (P<0.05). Logistic regression analysis showed that smoking, anxiety and symptoms of gastroesophageal reflux disease were independent risk factors for laryngopharyngeal reflux. Conclusions: The prevalences of LPRD, anxiety and depression in the otorhinolaryngology clinic are 13.59%, 8.19% and 6.84%, respectively. Among patients with laryngopharyngeal reflux, the prevalence of anxiety is 29.14%, and the prevalence of depression is 17.22%. Age, smoking, drinking, alcohol consumption, education level, course of disease, symptoms of gastroesophageal reflux disease, pharyngeal foreign body sensation, etc. are related to LPRD. Mental factors (anxiety and depression) may play a role in LPRD. Smoking, anxiety symptoms and symptoms of gastroesophageal reflux disease are closely related to the incidence of LPRD.
目的： 获得耳鼻咽喉科门诊中咽喉反流性疾病（laryngopharyngeal reflux disease，LPRD）及焦虑、抑郁患者的患病率；探讨精神心理因素（焦虑和抑郁）在其发病中的作用。 方法： 采用反流症状指数（reflux symptom index，RSI）量表、综合医院焦虑抑郁（hospital anxiety and depression，HAD）量表对2017年7月至2018年6月，北京大学人民医院耳鼻咽喉头颈外科门诊的1 111例患者进行问卷调查（男486例，女625例，年龄18~96岁，中位年龄38[30，53]岁）。获得LPRD及焦虑、抑郁患病率。病例组选取RSI阳性患者，对照组选择RSI阴性患者，比较两组间HAD评分的差异，并对咽喉反流的危险因素进行分析。采用SPSS 20.0软件进行统计学分析。 结果： 病例组151例，对照组960例，LPRD患病率为13.59%（151/1 111）。不同性别LPRD患病率差异无统计学意义（P>0.05）。18~40岁年龄段患病率最高，各个年龄段（18~40岁、41~65岁、>65岁）患病率比较差异有统计学意义（P<0.05）。吸烟、饮酒者的LPRD患病率均较非吸烟、饮酒者高，两组患病率比较差异有统计学意义（P<0.05）。RSI量表最常见的症状为咽喉异物感（92.72%，140/151）、持续清嗓（88.74%，134/151）、痰过多或鼻涕倒流（82.12%，124/151），两组间各症状差异均有统计学意义（P<0.05）。焦虑患者共91例，患病率为8.19%（91/1 111）；抑郁患者共76例，患病率为6.84%（76/1 111）。LPRD患者中，综合医院焦虑量表评分阳性占29.14%（44/151），综合医院抑郁量表评分阳性占17.22%（26/151）。LPRD组的焦虑症状、抑郁症状得分均高于非LPRD组，两组间上述各评分差异均具有统计学意义（P<0.05）。Logistic回归分析显示吸烟、焦虑、胃食管反流病症状为咽喉反流发病的独立危险因素。 结论： 耳鼻咽喉科门诊中LPRD患病率为13.59%，焦虑患病率为8.19%，抑郁患病率为6.84%。咽喉反流患者中，焦虑患病率为29.14%，抑郁患病率17.22%。年龄、吸烟、饮酒、文化程度、病程、胃食管反流病症状、咽部异物感等与LPRD相关。精神因素（焦虑、抑郁）可能在LPRD中发挥作用。吸烟、焦虑、胃食管反流病症状与LPRD发病有较密切的关系。.
Keywords: Anxiety; Depression; Hospital anxiety and depression scale; Laryngopharyngeal reflux; Reflux symptom index scale.