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首页> 外文期刊>Auris, nasus, larynx >Angioedema: 6 years experience with fourteen cases.
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Angioedema: 6 years experience with fourteen cases.

机译：血管性水肿：6年经验，共14例。

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OBJECTIVE: To study the difference in the findings between the causes of angioedema and the characteristics of angioedema induced by angiotensin receptor II blockers (ARBs), and to investigate whether laboratory examinations for acute phase inflammatory markers can aid in diagnosis and predict airway risk. METHODS: We retrospectively reviewed fourteen cases of patients with angioedema that were treated from 2000 to 2006. Data were collected regarding age, sex, location of the edema, cause, time course of resolution and laboratory examinations (leukocyte counts, serum C-reactive protein (CRP) level, complement function and the activity of C1 esterase inhibitor). RESULTS: The causes of angioedema were ACEIs in six patients (42.9%), candesartan (ARB) in three (21.4%), HAE (types 1 and 2) in two, and unknown in three. Of these patients, 71.4% exhibited edema in the floor of the mouth, irrespective of the cause. Two patients with edema induced by candesartan exhibited both lingual and laryngeal edemas. The remaining one with candesartan-induced edema exhibited edema in the neck and mediastinum and pleural effusion. The average time to resolution was 4.1 days, ranging from one to twelve days. The edema in eleven patients resolved with conservative therapy, while three patients underwent tracheotomy. In two patients with candesartan-induced edema, although the edemas resolved completely after cessation of candesartan administration, the edemas reappeared in the same locations, two and thirty days after the cessation of candesartan for each patient. None of the patients with angioedema induced by ACEIs exhibited elevation of serum CRP levels. No significant differences were found for leukocyte counts and serum CRP levels between patients with angioedemas induced by ACEIs, ARB and those of unknown cause. No significant differences were observed in the above findings between the patients who underwent tracheotomy and those who did not. Two patients exhibited low C4 levels, and one of the two exhibited no activity of C1 esterase inhibitor. CONCLUSION: Consistent with previous reports, angioedema in the floor of the mouth extending to the tongue should be considered as a possible risk factor for airway compromise. Laboratory examinations for acute phase inflammatory markers are not useful for diagnosis and are not predictive for airway intubation and tracheotomy. Angioedema induced by candesartan can present in anomalous sites and reappear following drug cessation even if the edema has resolved completely.
机译：目的：研究血管性水肿病因与血管紧张素Ⅱ受体阻滞剂（ARBs）引起的血管性水肿特征之间的差异，并研究实验室检查急性期炎症标志物是否有助于诊断和预测气道危险。方法：我们回顾性研究了2000年至2006年治疗的14例血管性水肿患者。收集了有关年龄，性别，水肿部位，病因，消退的时程和实验室检查（白细胞计数，血清C反应蛋白）的数据。 （CRP）水平，补体功能和C1酯酶抑制剂的活性）。结果：血管性水肿的原因是6例（42.9％）的ACEIs，3例（21.4％）的坎地沙坦（ARB），2例的HAE（1型和2型）和3例未知。在这些患者中，无论原因如何，71.4％的患者都出现了口底水肿。坎地沙坦诱发的两名水肿患者同时表现出舌和喉水肿。其余患有坎地沙坦诱导的水肿的人在颈部，纵隔和胸腔积液中表现出水肿。解决问题的平均时间为4.1天，从一到十二天不等。保守治疗可治愈11例患者的水肿，而气管切开术则可治疗3例。在两名患有坎地沙坦诱导的水肿的患者中，尽管在停止坎地沙坦治疗后水肿完全消失，但每位患者在停止坎地沙坦治疗后两天和三十天，水肿再次出现在相同的位置。 ACEIs引起的血管性水肿患者均未显示血清CRP水平升高。在ACEI，ARB和未知原因引起的血管性水肿患者之间，白细胞计数和血清CRP水平没有显着差异。在进行气管切开术的患者与未进行气管切开术的患者之间，上述发现没有显着差异。两名患者的C4水平低，而两名患者中的一名没有C1酯酶抑制剂的活性。结论：与以前的报道一致，应将口底延伸至舌头的血管性水肿视为可能影响气道损害的危险因素。急性期炎症标志物的实验室检查对诊断没有帮助，也不能预测气管插管和气管切开术。坎地沙坦诱发的血管性水肿可出现在异常部位，并且在停药后再次出现，即使水肿已完全缓解。

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