Church A C, Goldsmith K, Sivasothy P
Scottish Pulmonary Vascular Unit, Golden Jubilee Hospital, Glasgow, Scotland G81 4HX, UK.
J Laryngol Otol. 2010 Apr;124(4):393-6. doi: 10.1017/S0022215109991952. Epub 2009 Nov 25.
In patients with Wegener's granulomatosis, subglottic stenosis can develop due to active disease; however, some patients develop subglottic stenosis with no clear evidence of airway inflammation. In some cases of idiopathic subglottic stenosis, an association with gastroesophageal reflux disease has been found. Our study assessed the potential role of gastroesophageal reflux as an aetiological factor in the development of subglottic stenosis in patients with Wegener's granulomatosis.
We assessed evidence of active reflux disease, using 24-hour pH monitoring and assessment of bile salts in bronchoalveolar lavage fluid.
Ten Wegener's granulomatosis patients with subglottic stenosis underwent 24-hour pH monitoring and bronchoscopy and lavage of the right middle lobe. A similar number of control patients were included.
There was no statistically significant difference in the occurrence of bronchoalveolar bile salts in patients with subglottic stenosis (n = 2) versus control patients (zero) (p = 0.457). There was good correlation between the detection of reflux by 24-hour pH monitoring and the detection of bronchoalveolar bile salts (kappa = 0.769).
In this small study of patients with Wegener's granulomatosis, there was no evidence of an association between the development of subglottic stenosis and gastroesophageal reflux.
在韦格纳肉芽肿患者中，声门下狭窄可因疾病活动而发生；然而，一些患者出现声门下狭窄时并无明确的气道炎症证据。在某些特发性声门下狭窄病例中，已发现与胃食管反流病有关联。我们的研究评估了胃食管反流作为韦格纳肉芽肿患者声门下狭窄发病病因学因素的潜在作用。
我们采用24小时pH监测及支气管肺泡灌洗液中胆汁盐评估，来评估活动性反流病的证据。
10例有声门下狭窄的韦格纳肉芽肿患者接受了24小时pH监测、支气管镜检查及右中叶灌洗。纳入了数量相近的对照患者。
声门下狭窄患者（n = 2）与对照患者（0例）支气管肺泡胆汁盐的发生率无统计学显著差异（p = 0.457）。24小时pH监测检测到的反流与支气管肺泡胆汁盐的检测之间存在良好相关性（kappa = 0.769）。
在这项针对韦格纳肉芽肿患者的小型研究中，没有证据表明声门下狭窄的发生与胃食管反流之间存在关联。
