嗜酸性肉芽肿性多血管炎伴喉部受累：文献综述及一项横断面前瞻性研究经验
Eosinophilic granulomatosis with polyangiitis and laryngeal involvement: review of the literature and a cross-sectional prospective experience.
作者信息
Seccia V, Cristofani-Mencacci L, Dallan I, Fortunato S, Bartoli M L, Sellari-Franceschini S, Latorre M, Paggiaro P L, Baldini C
机构信息
First Otorhinolaryngology Unit,Department of Neuroscience,Azienda Ospedaliero-Universitaria Pisana,Pisa,Italy.
Respiratory Pathophysiology Unit,Cardio-Thoracic and Vascular Department,Azienda Ospedaliero-Universitaria Pisana,Pisa,Italy.
出版信息
J Laryngol Otol. 2018 Jul;132(7):619-623. doi: 10.1017/S0022215118000737. Epub 2018 Jun 11.
BACKGROUND
Eosinophilic granulomatosis with polyangiitis and granulomatosis with polyangiitis show variable otorhinolaryngological involvement. Up to 14 per cent of granulomatosis with polyangiitis patients have subglottis involvement; little is known about the laryngeal involvement in eosinophilic granulomatosis with polyangiitis.
METHOD
A literature review was conducted, together with a prospective cross-sectional analysis of 43 eosinophilic granulomatosis with polyangiitis patients. All patients underwent fibre-optic laryngoscopy with narrow-band imaging, and completed health-related questionnaires.
RESULTS
The literature review showed only two cases of laryngeal involvement in eosinophilic granulomatosis with polyangiitis; in our cohort, no cases of subglottis stenosis were found, but local signs of laryngeal inflammation were present in 72 per cent of cases. Of the patients, 16.2 per cent had a pathological Reflux Finding Score (of 7 or higher).
CONCLUSION
Laryngeal inflammation in eosinophilic granulomatosis with polyangiitis is frequent. It is possibly due more to local factors than to eosinophilic granulomatosis with polyangiitis itself. However, ENT evaluation is needed to rule out possible subglottis inflammation. These findings are in line with current literature and worthy of confirmation in larger cohorts.
背景
嗜酸性肉芽肿性多血管炎和肉芽肿性多血管炎表现出不同程度的耳鼻咽喉受累情况。高达14%的肉芽肿性多血管炎患者有声门下受累；关于嗜酸性肉芽肿性多血管炎的喉部受累情况知之甚少。
方法
进行了一项文献综述，并对43例嗜酸性肉芽肿性多血管炎患者进行了前瞻性横断面分析。所有患者均接受了窄带成像纤维喉镜检查，并完成了与健康相关的问卷调查。
结果
文献综述仅显示2例嗜酸性肉芽肿性多血管炎喉部受累病例；在我们的队列中，未发现声门下狭窄病例，但72%的病例存在喉部炎症的局部体征。16.2%的患者病理反流评分（7分或更高）。
结论
嗜酸性肉芽肿性多血管炎的喉部炎症很常见。这可能更多是由于局部因素而非嗜酸性肉芽肿性多血管炎本身。然而，需要耳鼻喉科评估以排除可能的声门下炎症。这些发现与当前文献一致，值得在更大的队列中进行证实。
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