Objective: To discuss the relationship between lingual tonsil hypertrophy and laryngopharyngeal reflux. Methods: Ninety-two patients who received throat surgery in Nanfang Hospital between October 2015 and October 2016 were enrolled. Twenty-six healthy volunteers were recruited as normal controls. All participants were assessed with the reflux finding score(RFS) and the size of lingual tonsils were evaluated using a clinical grading system proposed by Friedman under electronic laryngoscope. The score of reflux symptom index(RSI), personal history and medical history were gathered. Biopsy specimens of lingual tonsils were taken from all participants for the immunohistochemical stain of pepsin.SPSS 19.0 software was used for statistical analysis. Results: There were 46.2% (12/26) pepsin-positive and 53.8% (14/26) pepsin-negative volunteers in normal controls. There were 87.0% (80/92) pepsin-positive and 13.0% (12/92) pepsin-negative patients in study group. The severity of lingual tonsil hypertrophy and expression intensity of pepsin in patients were significantly higher in volunteers (Z=-3.636, Z=-5.273, P<0.01). The severity of lingual tonsil hypertrophy was positively associated with the pepsin level in patients (r=0.556, P<0.01). The patients with pepsin-positive expression showed significant correlation between lingual tonsil hypertrophy and the positive rate of RSI and RFS (r=0.258, r=0.225, P<0.05). Analysis of correlated factors indicated that lingual tonsil hypertrophy was associated with smoking (χ(2)=8.502, P<0.05). Conclusions: The expression of pepsin can be detected in lingual tonsil tissues. The lingual tonsil hypertrophy is closely related to laryngopharyngeal reflux.
目的： 探讨舌扁桃体肥大与咽喉反流是否存在相关性。 方法： 纳入2015年10月至2016年10月就诊于南方医院拟行咽喉手术的患者92例，招募健康志愿者26名，通过电子喉镜观察评估舌扁桃体大小，按Friedman分级方法分级；对2组参与研究者进行反流症状指数评分量表(reflux symptom index，RSI)、反流体征评分量表(reflux finding score，RFS)评分；记录参与研究者的个人生活史及病史；取每个参与研究者少量舌扁桃体组织，行胃蛋白酶免疫组化染色。应用SPSS 19.0进行统计学分析。 结果： 正常组26名舌扁桃体组织胃蛋白酶表达阳性率为46.2%(12/26)，阴性率为53.8%(14/26)；患者组92例舌扁桃体组织胃蛋白酶表达阳性率为87.0%(80/92)，阴性率为13.0%(12/92)，患者组舌扁桃体肥大程度和胃蛋白酶的表达强度均高于正常组，差异有统计学意义(Z＝－3.636，Z＝－5.273，P值均<0.01)。患者组中舌扁桃体肥大程度与胃蛋白酶的表达强度呈正相关(r＝0.556，P<0.01)，在患者组胃蛋白酶表达为阳性结果的患者中，舌扁桃体肥大与RFS、RSI评分阳性率之间存在正相关(r＝0.258，r＝0.225，P值均<0.05)。相关因素分析表明患者组舌扁桃体肥大与吸烟史之间存在显著性相关(χ(2)＝8.502，P<0.05)。 结论： 舌扁桃体肥大淋巴组织中存在胃蛋白酶的表达，提示舌扁桃体肥大与咽喉反流存在相关性。.
Keywords: Laryngopharyngeal reflux; Lingual tonsil hypertrophy; Pepsin.