Stolovitzky J P, Todd N W
Section of Otolaryngology, Emory University School of Medicine, Atlanta, GA.
Laryngoscope. 1990 Mar;100(3):227-30. doi: 10.1288/00005537-199003000-00003.
Acquired subglottic stenosis is a devastating additional burden for nearly 4% of premature infants receiving neonatal intensive care. The duration of endotracheal intubation is considered the most important etiologic factor. Surprisingly, most premature infants do not acquire subglottic stenosis. Infants with similar clinical characteristics and care have varying laryngeal outcomes. We hypothesized an autoimmune mechanism to type-II collagen to explain the varying laryngeal outcomes of these infants. A retrospective study of premature infants of comparable birth weight, gestational age, and duration of endotracheal intubation was conducted. The eight control children, who did not manifest symptoms of airway obstruction, had longer durations of intubation than did the infants who developed subglottic stenosis. Three of five affected infants had serum antibodies to type-II collagen, in contrast to none of the control infants (P = .035). This finding warrants additional study, and might lead to new diagnostic and therapeutic measures for these patients.
获得性声门下狭窄是近4%接受新生儿重症监护的早产儿的一个严重额外负担。气管插管时间被认为是最重要的病因因素。令人惊讶的是，大多数早产儿并未患上声门下狭窄。具有相似临床特征和护理情况的婴儿有不同的喉部结局。我们推测针对II型胶原蛋白的自身免疫机制可解释这些婴儿不同的喉部结局。对出生体重、胎龄和气管插管时间相当的早产儿进行了一项回顾性研究。8名未出现气道梗阻症状的对照儿童的插管时间比发生声门下狭窄的婴儿更长。5名患病婴儿中有3名有针对II型胶原蛋白的血清抗体，而对照婴儿中无一例有此情况（P = 0.035）。这一发现值得进一步研究，可能会为这些患者带来新的诊断和治疗措施。
