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[血管紧张素转换酶抑制剂治疗高血压后发生的慢性增生性喉炎]

[Chronic hyperplastic laryngitis following treatment of hypertension with angiotensin converting enzyme-inhibitor].

作者信息

Fuchs M, Bücheler M

机构信息

Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde/Plastische Operationen der Universität Leipzig.

出版信息

HNO. 2004 Nov;52(11):998-1000. doi: 10.1007/s00106-003-1016-6.

Abstract

We report the case of a 42 year old patient who developed chronic hyperplastic laryngitis during treatment with the angiotensin converting enzyme-inhibitor Cibacen 10. A severe cough and vocal restrictions with hoarseness were only incompletely cured after changing this anti-hypertensive medication to a adrenergic blocker, combined with a vocal rest and anti-inflammatory inhalation. Therefore we performed a laryngoscopy under general anesthesia and excised the swelling of the vocal cords. Additionally, voice therapy was prescribed and complete restitution achieved. Although hoarseness is documented as a potential side effect of angiotensin converting enzyme-inhibitors, morphological alterations in the vocal cords have not been linked to this type of drug. In our case, prolonged medication with Cibacen 10 led to chronic hyperplastic laryngitis. Initial coughing might have induced the trauma of the epithelium of the vocal cords. Due to the morphological alterations to the vocal cords the patient developed additional functional dysphonia.

摘要

我们报告了一名42岁患者的病例,该患者在使用血管紧张素转换酶抑制剂西拉普利10进行治疗期间患上了慢性增生性喉炎。在将这种抗高血压药物换成肾上腺素能阻滞剂,并结合声带休息和抗炎吸入治疗后,严重咳嗽以及伴有声音嘶哑的声带受限症状仅得到部分缓解。因此,我们在全身麻醉下进行了喉镜检查,并切除了声带肿胀组织。此外,还进行了嗓音治疗,患者最终完全康复。尽管声音嘶哑被记录为血管紧张素转换酶抑制剂的一种潜在副作用,但声带的形态学改变与这类药物并无关联。在我们的病例中,长期服用西拉普利10导致了慢性增生性喉炎。最初的咳嗽可能引发了声带上皮的损伤。由于声带的形态学改变,患者继而出现了功能性发音障碍。

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