咽喉反流在任克间隙水肿发病中的作用  

The role of laryngopharyngeal reflux in the pathogenesis of Reinke′s edema

作　　者：王嘉森[1] 李进让[1] 

机构地区：[1]海军总医院耳鼻咽喉头颈外科,北京100048

出　　处：《临床耳鼻咽喉头颈外科杂志》2016年第24期1931-1934,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：海军总医院创新培育基金(No:CXPY201624)

摘　　要：目的:探讨咽喉反流在任克间隙水肿发病中的作用。方法:选取2014-02-2016-06诊断为任克间隙水肿的16例患者进行分析,以同期声带白斑和早期声门型喉癌50例患者作为对照组,对比分析两组间反流症状指数(RSI)、反流体征评分(RFS)、24h咽喉酸反流次数、24h咽喉酸反流时间和咽喉反流阳性率的差异。结果:任克间隙水肿患者的RSI评分均值为11.2±3.8,RFS评分均值为8.2±1.5,中位反流次数4.0[0.0;9.0]次,中位反流时间5.6[0.0;16.7]min,量表评分咽喉反流阳性率100%(16/16),24hMII-pH监测结果示咽喉反流阳性率56.2%(9/16);对照组RSI评分均值为8.6±3.2,RFS评分均值为6.8±2.1,中位反流次数0.0[0.0;3.0]次,中位反流时间0.0[0.0;4.3]min,量表评分咽喉反流阳性率58.0%(29/50),24hMII-pH监测结果示咽喉反流阳性率28.0%(14/50)。任克间隙水肿组RSI评分、RFS评分、24h咽喉酸反流次数、24h咽喉酸反流时间和咽喉反流阳性率均显著高于对照组,差异有统计学意义(P<0.01或P<0.05)。结论:咽喉反流与任克间隙水肿具有相关性,咽喉反流在任克间隙水肿发病中起一定作用,对任克间隙水肿患者治疗时应加抑酸治疗。Objective： To determine the significance of laryngopharyngeal reflux（LPR） in Reinke＇s edema. Method：Sixteen patients who have been diagnosed as Reinke＇s edema between February 2014 to June 2016 were in eluded in this study. The control group included fifty vocal cord leukoplakia and early glottic cancer patients for the corresponding period. RSI,RFS,numbers of laryngopharyngeal acid reflux events,and time of laryngopharyn- geal acid exposure were evaluated between two groups. Result：The mean RSI of the Reinke＇s edema was 11.2± 3.8, the mean RFS was 8.2± 1.5, the median numbers of laryngopharyngeal acid reflux events was 4.0[0.0;9.02, the time of laryngopbaryngeal acid exposure was 5.6[0.0; 16.7]min. The rate of LPR positive in Reinke＇s edema patients was 100.0%（16/16）by RS1 and RFS,56.2%（9/16）by 24 hour MII-pH monitoring. The mean RSI of the control group was 8.6± 3.2, the mean RFS was 6.8± 2. 1, the median numbers of laryngopharyngeal acid reflux events was 0. 0[0. 0 ; 3. 0], the time of laryngopharyngea[ acid exposure was 0.0 [0.0;4. 3] min. The rate of LPR positive in control group was 58. 0% （29/50）by RSI and RFS, 28.0% （14/50）by 24 hour MII-pH monitoring. There were statistically significance in RSI,RFS,numbers of laryngopharyngeal acid reflux events, and time of la- ryngopharyngeal acid exposure between two groups（P〈0.01 or P〈0.05）. Conclusion： Laryngopharyngeal reflux might play a role as an etiologic factor in Reinke＇s edema,awareness should increase about acid suppression therapy in Reinke＇s edema.

关 键 词：咽喉反流 任克间隙水肿 反流症状指数 反流体征评分 

分 类 号：R767.4[医药卫生—耳鼻咽喉科]