| laryngopharyngeal reflux(LPR)refers to the abnormal gastric contents reflux into the upper respiratory tract and cause symptoms of a chronic or mucosa damage,clinical manifestations of the pronunciation is difficult,the main voice hoarse,frequent hawk,irritating cough and other symptoms.With the emergence of lifestyle,poor eating habits,the continuous improvement of material life,to predict the future incidence of pharyngeal reflux will gradually rise.Pepsin only in gastric mucosal cells secrete Lord,it is generally believed that the organs of the upper respiratory tract mucous membrane or detect the expression of pepsin secretion,it indicates that the throat reflux happened.Pepsin as an important biological indicators of throat reflux,many research has been confirmed and otolaryngology disease are closely related,such as vocal cords leukoplakia,sore throat,throat cancer,chronic sinusitis,pediatric secretory otitis media.But clinically pepsin and tonsil hypertrophy of the correlation research rarely reported..Once thought throat reflux is the gold standard of double probe laryngeal pharynx esophagus 24 hours ph detection,but later found its low sensitivity,a high rate of false positive(negative),invasive operation,expensive,the results are greatly influenced by the electrode placement,the check is not widely used in clinical.The consequent sputum pepsin ELASA assay,its operation is simple,use convenient,noninvasive examination,and high degree of sensitivity and specific,some scholars think is better a detection means.Due to large variation in content of pepsin in 24 hours,the best time to start collecting specimens have been controversial,and studies have shown that normal people there is also a physiologic reflux,sputum also contains a certain amount of pepsin,so some scholars question the testing is not accurate,high rate of false positives.So to avoid the above shortcomings,this studyadoptsacommonpathologicaldiagnosismethod(immunohistochemistry)to test the tonsil hypertrophy group,to observe the expression of pepsin,studying whether tonsil hypertrophy and your throat no correlation between reflux,in the hope of the future for early prevention of tonsil hypertrophy,standardized diagnosis and reasonable treatment provides a new research direction and way.Objective:To discuss the relationship between tonsil hypertrophy and laryngopharyngeal reflux.Methods:1 General InformationSelection in February 2017 to October 2017 from Chengde medical school affiliated hospital otolaryngology,67 patients with surgical treatment of tonsil hypertrophy,according to the age is divided into children series and adults size,47children cases(3~15 years of age);20 adults cases(20~60years old).In clinical practice,the tonsils are divided into three degrees according to their size.First degree:tonsil is not more than palatal pharyngeal;Second degree:the tonsil exceeds the palatopharyngeal arch but has not reached the midline;Third degree:the tonsils above the midline.2 The specimen is basedImports should be used in all patients with low temperature plasma knife tonsils removed,all specimens were collected by the author himself and fixed preservation,the contents of pepsin in tonsil tissue were detected by immunohistochemical staining of gastric protease.3 The experimental processTaking volume equal to the size of the specimens were collected,and the amygdala,dehydration,paraffin embedding,sectioning,baking,to join the antibody,DAB chromogenic,neutral resin film,a microscope tonsil organization form.Results:The positive rate of expression of pepsin in 47 children was 53.19%(25/47),with a negative rate of 46.81%(22/47);the positive rate of expression of pepsin in 20 adults was 90.00%(18/20),with a negative rate of10.00%(2/20).The difference in the expression of pepsin in the two groups was statistically significant(χ~2=8.268,P=0.004).The degree of tonsil hypertrophy in children group was positively correlated with the expression intensity of pepsin(r=0.406,P<0.05),and there was no correlation between tonsil hypertrophy of the adult group and the expression intensity of pepsin(r=0.099,P>0.05).Conclusion:The expression of pepsin was found in both groups of patients with tonsil hypertrophy,indicating the correlation between tonsil hypertrophy and laryngopharyngeal reflux. |
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