男性喉局部淀粉样变发生与谷丙转氨酶异常相关性

doi:10.6040/j.issn.1673-3770.0.2025.052

摘要/Abstract

摘要： 目的对喉局部淀粉样变(localized amyloidosis, LA)的临床特征进行回顾性描述分析,寻找与发病可能相关的生化指标。方法对病理学诊断的喉LA患者病案记录的临床症状及血生化测定数据进行描述分析,采用病例-对照研究方法二分类Logistic回归分析男女喉LA患者有关联的危险性因素。结果 46例喉LA患者的总体描述:男31例、女15例,男女比为2.07∶1.00,初诊年龄为45.66岁,主要症状为声嘶。喉LA病变部位,单侧声带18例、双侧声带16例、非声门区12例。确诊前声嘶症状持续时间长,平均(86.57±32.52)个月。37例喉LA接受了喉镜下CO₂激光切除、余者6例为喉镜下常规手术治疗,仅1例在术后10年复发。中位随访期为10.61年,只有1例术后1年半死于脑出血,其它患者都存活,存活率为97.8%。男女喉LA患者的比较分析:男性谷丙转氨酶(alanine aminotransferase, ALT)、谷草转氨酶(aspartate transaminase, AST)和谷氨酰转肽酶(gamma-glutamyl transferase, GGT)高于女性,差异有统计学意义。在互为调整因素的回归分析中,发现谷丙转氨酶水平升高与男性喉LA的危险性有一定关联(OR=1.461, 95%CI=1.021~2.090, P=0.038)。结论喉LA主要症状为声嘶,诊断前持续时间很长,男性罹患多于女性,手术切除效果很好,经过10年随访存活率在95%以上。性别比较提示ALT升高可能与男性喉LA的危险性有关联,但尚需多中心更大样本前瞻性研究证实。

关键词: 喉, 局部淀粉样变, 丙氨酸氨基转移酶(谷丙转氨酶), 谷草转氨酶, 谷氨酰转肽酶

Abstract: Objective To perform a retrospective descriptive analysis of the clinical features of localized amyloidosis(LA)of the larynx and to search for biochemical indicators that may be associated with pathogenesis. Methods Clinical symptoms and blood biochemical measurement data from case records of patients with pathologically diagnosed laryngeal LA were descriptively analyzed, and risk factors associated with laryngeal LA in men and women were analyzed by binary logistic regression using case-control study methodology. Results 1.General description of the 46 patients with laryngeal LA: 31 males and 15 females, male-to-female ratio of 2.07∶1.00, age at first diagnosis of 46 years old, and main symptom of hoarseness. The site of laryngeal LA lesions, unilateral vocal folds in 18 cases, bilateral vocal folds in 16 cases, and non-vocal area in 12 cases. The duration of hoarseness symptoms before diagnosis was long, with a mean of(86.57±32.52)months. 37 cases of laryngeal LA underwent laryngoscopic CO₂ laser resection, and the remaining 6 were treated with conventional laryngoscopic surgery, and only 1 case recurred 10 years after surgery. The median follow-up period was 10.61 years, and only one case died of cerebral hemorrhage 1.5 years after surgery, and all other patients survived, with a survival rate of 97.8%. 2.Comparative analysis of male and female patients with laryngeal LA: males had higher levels of alanine aminotransferase(ALT), aspartate aminotransaminase(AST), and gamma-glutamyl transpeptidase(GGT)than women, and the difference was statistically significant. In the regression analysis with reciprocal adjusting factors, an association was found between elevated ALT levels and the risk of laryngeal LA in men(OR=1.461,95%CI=1.021-2.090, P=0.038). Conclusion Laryngeal LA, whose main symptom is hoarseness and which lasts for a long time before diagnosis, is more frequent in men than in women, and surgical resection is highly effective,with a survival rate of more than 95% after 10 years of follow-up. The gender comparison suggests that elevated ALT may be associated with the risk of laryngeal LA in men, but multicenter prospective studies with larger samples are needed to confirm this.

Key words: Throat, Localized amyloidosis, Alanine aminotransferase, Aspartate transaminase, Gamma-glutamyl transferase

中图分类号:

R767.19

李芃泽,于霜,王加锋. 男性喉局部淀粉样变发生与谷丙转氨酶异常相关性[J]. 山东大学耳鼻喉眼学报, 2025, 39(3): 135-140.

LI Pengze, YU Shuang, WANG Jiafeng. Correlation between the occurrence of localized amyloidosis of the larynx and abnormalities of glutathione in men[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(3): 135-140.

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