吸入糖皮质激素.doc

1 Inhaled corticosteroids: hazardous effects on voice-an update. 吸入糖皮质激素:有害影响语音更新。 Department of Clinical Surgery, University of Massachusetts Medical School, Worcester, Massachusetts, USA. 摘要: Inhaled corticosteroids (ICS) have e the prevalent treatment in asthmatics. Hazards to voice are under-recognized. A total of 38 patients with plaints associated with the use of ICS were assessed by 79 strobovideolaryngoscopy (SVL) examinations, 24 single and 14 multiple SVL. Hoarseness and dysphonia were the primary reasons for referral. The ICS initially used most frequently was Advair Diskus (fluticasone propionate and salmeterol-inhalation powder-[IP]) in 22 patients, followed by Flovent (fluticasone propionate inhalation aerosol-pressurized metered-dose inhaler-[PMDI]) in 11. Duration of ICS usage varied from 2 weeks to 4-5 years. Higher dosage and frequency of use exacerbated problems. Hazards to voice previously unrecognized by real-time indirect mirror or fiberoptic laryngoscopy were identified by meticulous attention to SVL abnormalities. There was essentially no difference in occurrence of abnormalities whether analyzed from the perspective of the initial 38 or all 79 examinations. These included abnormal mucosal wave symmetry/periodicity (76-63%), phase closure (74-63%), glottic closure (63-59%), mucosal wave amplitude/magnitude (50-35%), supraglottic hyperactivity (39-25%), mucosal quality (34-34%), and glottic plane (10-5%).Candidiasis of the larynx was infrequently observed. Fluticasone ICS were a cause of steroid inhaler laryngitis, and the best treatment was their avoidance or cessation. Further prospective studies ideally might include SVL documented as a pretherapy baseline and then repeated in each ICS patient who developed hoarseness/dysphonia. 参考中文摘要: 吸入糖皮质激素( ICS ) 的流行, 已成为治疗哮喘。危害声音受到公认。一共有 38例语音投诉与使用 ICS 的是由 79 strobovideolaryngoscopy ( SVL )考试, 24 日和 14 多个单 SVL 。声嘶和发音障碍是最主要的原因在于推介。 ICS 的最初最常使用的是 Advair 吸入( 丙酸***替卡松和沙美特罗吸入粉末[ 知识产权]) 22例, 其次是 Flovent (替卡松