过度活动患者的诱发性喉梗阻
Inducible Laryngeal Obstruction in Hypermobile Patients.
文献信息
| PMID | 42860825 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Stacey M Menton |
| 作者单位 | Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Jacksonville, Florida, USA. |
| 期刊 | The Laryngoscope |
| SCI 分区 | Q2 |
| IF | 2.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 确定患有过度活动型埃勒斯-当洛斯综合征（hEDS）或过度活动谱系障碍（HSD）并伴有诱发性喉梗阻（ILO）的患者，是否比不伴有ILO的患者有更多的嗓音、咳嗽、吞咽、胃肠道问题以及肥大细胞（MC）激活。
方法： 这项回顾性研究纳入了2019年11月至2025年6月在佛罗里达州梅奥诊所EDS门诊就诊的2162例符合2017年hEDS（n=507）或HSD（n=1655）诊断标准的患者，比较了ILO筛查阳性与筛查阴性的患者。对患者进行了自我报告的嗓音、咳嗽、吞咽和胃肠道问题症状以及MC激活的检查。
结果： 在hEDS或HSD患者中，分别有23.1%和17.1%筛查为ILO阳性。伴有ILO的患者比不伴有ILO的患者有显著更多的嗓音、咳嗽和吞咽问题（所有p≤0.007）。两种诊断均有更多的胃食管反流病（GERD）（hEDS：55.6% vs. 40.9%，p=0.004；HSD：55.8% vs. 42.2%，p<0.0001）。此外，伴有ILO的hEDS和HSD患者比不伴有ILO的患者更频繁地自我报告18种过敏相关症状，并且具有更高的MC评分，表明存在广泛的MC激活（所有p<0.0001）。在logistic回归分析中，咳嗽、吞咽困难和MC评分升高是hEDS和HSD中ILO的统计学显著预测因素。
结论： 慢性咳嗽、吞咽困难和MC症状负担升高是hEDS和HSD中ILO的最强独立预测因素，强调了对该人群进行常规多学科喉部评估的必要性。
英文摘要
OBJECTIVE: To determine whether patients with hypermobile Ehlers-Danlos syndrome (hEDS) or hypermobility spectrum disorders (HSD) and inducible laryngeal obstruction (ILO) have more voice, cough, swallowing, GI issues, and MC activation than patients without ILO.
METHODS: This retrospective study of 2162 patients meeting 2017 diagnostic criteria for hEDS (n = 507) or HSD (n = 1655) who were seen at the EDS Clinic in Mayo Clinic Florida from November 2019 to June 2025 compared patients who screened positive for ILO to those who screened negative. Patients were examined for self-reported symptoms of voice, cough, swallow, and GI issues as well as MC activation.
RESULTS: Among patients with hEDS or HSD, 23.1% and 17.1% respectively screened positive for ILO. Patients with ILO had significantly more voice, cough, and swallow issues than patients without ILO (all p ≤ 0.007). Both diagnoses had more gastroesophageal reflux disease (GERD) (hEDS: 55.6% vs. 40.9%, p = 0.004; HSD: 55.8% vs. 42.2%, p < 0.0001). Additionally, both hEDS and HSD patients with ILO self-reported 18 allergy-related symptoms more often than those without ILO and had higher MC scores indicating widespread MC activation (all p < 0.0001). Cough, dysphagia, and elevated MC score were statistically significant predictors of ILO in both hEDS and HSD within a logistic regression analysis.
CONCLUSIONS: Chronic cough, dysphagia, and elevated MC symptom burden were the strongest independent predictors of ILO across both hEDS and HSD, underscoring the need for routine multidisciplinary laryngeal assessment in this population.