声带任克水肿与咽喉反流的相关性研究  

The Correlation Analysis of the Laryngopharyngeal Reflux and Reinke's Edema

作　　者：龚霞[1] 王晓云[1] 杨丽[2] 杜俊[2] 张伟[2] Gong Xia;Wang Xiaoyun;Yang Li;Du Jun;Zhang Wei(Department of Otolaryngology,Beijing Hospital,National Centerof Gerontology,Beijing,100730,China)

机构地区：[1]国家老年医学研究中心北京医院耳鼻咽喉科,北京100730 [2]国家老年医学研究中心北京医院病理科

出　　处：《听力学及言语疾病杂志》2018年第6期635-637,共3页Journal of Audiology and Speech Pathology

摘　　要：目的初步探讨咽喉反流与声带任克水肿的相关性。方法选取2015年1月～2017年12月期间首诊诊断为声带任克水肿并采取手术治疗的32例患者的声带病理标本作为任克水肿组,选取同期行尸检的29例喉部正常者声带组织标本作为对照组;采用免疫组化方法检测两组标本中胃蛋白酶含量,参照Formwitz评分方法,对阳性细胞的阳性率及显色进行分级,据二者的乘积将染色程度分为阴性、弱阳性、阳性、强阳性4级。比较两组声带组织中胃蛋白酶检测阳性率及免疫组化染色结果。结果任克水肿组声带病变组织中胃蛋白酶强阳性5例(15.63%),阳性13例(40.63%),弱阳性8例(25.0%),阴性6例(18.75%);对照组声带组织无胃蛋白酶强阳性及阳性标本,弱阳性4例(13.79%),阴性25例(86.21%),前者阳性率高于后者,差异有显著统计学意义(χ2=30.906,P<0.001)。结论任克水肿患者声带组织中胃蛋白酶含量高于正常声带者,咽喉反流可能是导致声带任克水肿发生的危险因素之一。Objective To study the correlation of laryngopharyngeal reflux with Reinke's edema through the pepsin immunohistochemistry detection of Reinke's edema specimens.Methods The laryngeal specimens of 32 patients of Reinke's edema identified clinically from January,2015 to December,2017 and 29 autopsy cases in the same period were collected.An immunohistochemical analysis was used to detect pepsin.According to the method of Formwitz,their coloration condition and percentage of positive stained cells were calculated.By multiplying of the above two,immunohistochemical results were graded into 4 degrees.The result of these two groups were statistically analyzed.Results Five of 32(15.63%)Reinke's edema specimens strongly expressed pepsin,13 of which were positive(40.63%),8 were weakly positive(25.0%),and 6 were negative(18.75%).While,four of 29(13.79%)autopsy specimens showed weakly positive expressions of pepsin,25 of which were negative(86.21%)and none positive or noticeably positive.There were statistical differences of pepsin expression between these two groups(P<0.001).Conclusion Pepsin in the laryngopharyngeal reflux has correlation to Reinke's edema as a possible risk factor in the development of the Reinke's edema.

关 键 词：咽喉反流 任克水肿 胃蛋白酶 免疫组化 

分 类 号：R767.4[医药卫生—耳鼻咽喉科]