声带息肉组织胃蛋白酶表达情况对术后疗效的影响  

The effect of expression of pepsin in vocal polyps on postoperative curative effect

作　　者：孟洁 冯国建[2] 王德望[3] 刘亚群[1] 蔡明静 孙川 张庆翔[1] MENG Jie;FENG Guojian;WANG Dewang;LIU Yaqun;CAI Mingjing;SUN Chuan;ZHANG Qingxiang(Department of Otolaryngology Head and Neck Surgery,Nanjing Tongren Hospital,School of Medicine,Southeast University,Nanjing,211102,China;Department of Otolaryngology,Second People's Hospital of Lianyungang.Lianyungang Cancer Hospital;Department of Pathology,Nanjing Tongren Hospital.School of Medicine,Southeast University)

机构地区：[1]东南大学医学院附属南京同仁医院耳鼻咽喉头颈外科 南京同仁耳鼻喉医院,南京211102 [2]连云港市第二人民医院 连云港市肿瘤医院耳鼻咽喉科 [3]东南大学医学院附属南京同仁医院病理科

出　　处：《临床耳鼻咽喉头颈外科杂志》2022年第1期14-18,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨声带息肉组织胃蛋白酶表达情况对声带息肉术后疗效的影响。方法:回顾性分析2019年6月-2021年3月诊断为声带息肉并进行手术的112例患者资料.根据术后息肉组织免疫组织化学胃蛋白酶表达情况分为阳性组和阴性组,分析两组术前反流症状指数(RSI)和反流体征评分(RFS).并对比分析两组术后嗓音声学功能及声带形态的恢复情况。结果:112例声带息肉患者的术后标木中胃蛋白酶染色阳性76例(67.9%),阴性36例(32.1%);胃蛋白酶阳性组中.48例声带形态恢复正常,20例遗留术区瘢痕或水肿.8例息肉复发;胃蛋白酶阴性组中,32例声带形态恢复正常,4例遗留术区瘢痕或水肿.无息肉复发患者.两组比较.声带形态的恢复差异有统计学意义(χ^(2)=8.689,P=0.013).术后12周声嘶症状均改善.GRBAS评估的G分级、VHI、MPT、基频微扰和振幅微扰手术前后比较差异均有统计学意义(均P<0.05);术后G分级、VH1、MPT、基频微扰和振幅微扰在胃蛋白酶阳性组和胃蛋白酶阴性组之间的差异均有统计学恵义(均P<0.05)。结论:声带息肉组织中胃蛋白酶表达情况是影响术后声带声学效果及形态恢复的有意义的临床指标,术后组织学发现胃蛋门酶表达阳性者应加强抑酸治疗。Objective:To investigale the effect of tissue pepsin expression of vocal polyps on the postoperative curative effect.Methods:Retrospectively analyze the data of 112 patients diagnosed with vocal cord polyps and undergone surgery from June 2019 to March 2021.The cases were divided into positive group and negative group according to the immunohistochemical pepsin expression.The preoperative reflux symptom index(RSI)and the reflux finding score(RES)were compared.and the recovery of the voice acoustic function and postoperative vocal cord morphology were analyzed.Results:Among the postoperative specimens of 112 patienls,76 cases were positive for pepsin staining accounting for 67.9%and 36 cases were negative,accouniing for 32.1%.In lhe pepsinpositive group.48 cases of vocal cord morphology returned to normal.and 20 cases remained scar or edema in the operation area,8 cases of polyps relapsed;in the pepsin ncgative group,a total of 32 cases of vocal cord morphology returned to normal.4 cases of remained scar or edema in the operation area,no relapsed cases.the difference in vocal cord morphology recovery was significant(χ^(2)=8.689,P=0.013).The symptoms of hoarsencss improved after 12 weeks.The differences between pre and post operative of(;grade.VH1.MPT.fundamenlal frequency perturbation and amplitude perturbation assessed by GRBAS were significant(PV0.05);postoperative G grade.VHI.MPT.fundamental frequency perturbation and amplitude perturbation were compared between the pepsin-positive group and the pepsin-negative group,and the differences were significant(all PV0.05).Conclusion:The expression of pepsin in vocal polyps is a significant clinical indicator that affects the acoustic effect and morphological recovery of vocal cords after surgery.For patients with positive expression,acid suppression treatment should be st rengihened after surgery.

关 键 词：咽喉反流 声带息肉 反流症状指数 反流体征评分 胃蛋白酶 

分 类 号：R767.4[医药卫生—耳鼻咽喉科]