咽喉反流与声带良性增生性病变、声带白斑、慢性咽喉炎相关性研究  

Correlations between vocal cord hyperplastic lesions,vocal cord leukoplakia,chronic laryngopharyngitis,and laryngopharyngeal reflux

作　　者：王磊[1] 王刚[1,2] 孙喆喆 刘红丹 韩浩伦 李保卫[1] 张晓丽 吴玮[1,2] WANG Lei;WANG Gang;SUN Zhezhe;LIU Hongdan;HAN Haolun;LI Baowei;ZHANG Xiaoli;WU Wei(Department of Otolaryngology,the Ninth Medical Centerof Chinses PLA General Hospital,Beijing 100101,China;State Environmental Protection Key Laboratony of Enrironmental Sense Organ Stress and Health,Beijing 100101,China)

机构地区：[1]中国人民解放军总医院第九医学中心耳鼻喉科,北京100101 [2]国家环境保护环境感观应激与健康重点实验室,北京100101

出　　处：《山东大学耳鼻喉眼学报》2024年第6期71-77,共7页Journal of Otolaryngology and Ophthalmology of Shandong University

基　　金：战略技援部队特色医学中心中心级课题资助(编号19ZX48);学科建设助推计划资助项目(编号21XK0103)

摘　　要：目的 对比慢性咽喉炎探讨三种声带良性增生性病变、声带白斑与咽喉反流相关性。方法 回顾分析声带息肉92例、声带囊肿24例、任克水肿37例、声带白斑53例、慢性咽喉炎106例患者的反流相关量表评分、口咽pH监测结果,比较各组咽喉反流阳性率及反流相关参数差异,并纳入年龄、性别、烟酒嗜好进行多因素Logistic回归分析。结果 声带占位病变(良性增生性病变+白斑)较慢性咽喉炎组量表阳性率、口咽pH监测Ryan指数阳性率、W指数阳性率、pH6.0反流百分比时间有统计学差异(P<0.05)。白斑组反流症状指数量表阳性率最低,pH监测相关参数均高于良性增生性病变各组,结果存在统计学差异(P<0.05)。声带囊肿组W指数阳性率及W值仅次于白斑组。多因素分析,除了高龄、男性、吸烟,LPR是声带白斑的独立危险因素;以W指数为标准时,LPR是声带囊肿的危险因素。结论 咽喉反流与多种声带病变相关,声带良性增生性病变、声带白斑较非占位性咽喉炎与咽喉反流关系更密切,尤其声带白斑相关性最大。声带囊肿与LPR关系仍需进一步验证。Objective The purpose of this study was to explore the correlations between vocal cord hyperplastic lesions,vocal cord leukoplakia,chronic laryngopharyngitis,and laryngopharyngeal reflux(LPR).Methods A retrospective analysis of 153 patients with benign vocal cord hyperplastic lesions(including 92 cases of vocal cord polyps,24 cases of vocal cord cyst,and 37 cases of Reinke’s edema),53 patients with vocal cord leukoplakia,and 106 patients with chronic laryngopharyngitis was performed.Reflux symptom index(RSI),reflux finding score(RFS),and oropharyngeal pH monitoring results were analyzed.The positive rate of LPR and the reflux-related indexes of each group were compared.Multi-factor logistic regression analysis was performed and includ-ed age,sex,smoking,and drinking habits.Results The prevalence of LPR in the vocal cord lesion group(benign vocal cord hy-perplastic lesions and leukoplakia)was significantly higher than in the laryngopharyngitis group,according to the RSI,RFS,Ryan score,W score,and other parameters of oropharyngeal pH monitoring(P<0.05).The leukoplakia group had the lowest positive rate of RSI,but the reflux-related parameters of pH monitoring were significantly higher than those in other groups(P<0.05).The posi-tive rate and W score in the vocal cord cyst group were second to those in the leukoplakia group.Multivariate analysis showed that LPR was an independent risk factor for leukoplakia,except for old age,male,and smoking.LPR was also a risk factor for vocal cord cysts when W score was considered as the standard.Conclusions LPR is associated with a variety of laryngeal diseases.Vocal cord hyperplastic lesions and leukoplakia are related to LPR more closely than laryngopharyngitis disease,especially leukoplakia.Further studies to validate the relationship between vocal cord cysts and LPR are necessary.

关 键 词：咽喉反流 声带增生性病变 声带白斑 口咽pH监测 

分 类 号：R766.5[医药卫生—耳鼻咽喉科]