Laryngeal Mucous Membrane Pemphigoid: A Systematic Review and Pooled-Data Analysis
Laryngeal Mucous Membrane Pemphigoid: A Systematic Review and Pooled-Data Analysis
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DOI：
10.1002/lary.20763
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发表时间：
2010-03-01
期刊：
影响因子：
2.6
通讯作者：
Sinacori, John T.
中科院分区：
文献类型：
--
作者：
Higgins, Thomas S.;Cohen, Justin C.;Sinacori, John T.
目标/假设：为了进行一个系统的汇总数据分析的文献数据，涉及喉粘膜类天疱疮（MMP）。研究设计：一个系统的回顾和汇总数据analysis.Methods：我们进行了一个系统的文献检索MEDLINE，EMBASE，科克伦临床试验中心注册，科克伦系统性评价数据库，clinicaltrials.gov，和国家指南交换数据库，包括相关术语的组合研究，没有语言限制。所有作者独立筛选检索结果的摘要，识别符合综述条件的文章，并对全文研究进行批判性评价。使用SPSS 16.0版软件（SPSS Inc.，芝加哥，IL）。在审查的2，524篇引文中，纳入的文章包括63篇病例报告和10篇病例系列报告，涉及141例喉MMP患者。没有临床试验或比较试验被发现。喉MMP的总体计算患病率为MMP病例的12.2%（95%置信区间[CI]，11.5-12.9%），或一般人群中的1/1000万人。喉MMP发病时的平均年龄为59.7岁（95% CI，57.9-61.1岁），声门上是最常见的受累部位（84.8%，95% CI，82.5-87.2%）。性别间的分布相当（P = .655）。抗epiligrin自身抗体的存在与喉受累增加相关（比值比7.9，95%CI，3.9-16.0）。总的5年相对生存率为92.4%（标准误，8.4），随访范围为1至221个月。标准的药物治疗偶尔会改善病情;然而，复发频繁，10.5%最终需要气管切开术。喉部手术干预似乎是有效的严重cases.Conclusions：喉MMP是一种罕见的情况下，可以威胁生命，没有适当的治疗和频繁的后续行动。
Objectives/Hypothesis: To perform a systematic pooled-data analysis of literature data involving laryngeal mucous membrane pemphigoid (MMP).Study Design: A systematic review and pooled-data analysis.Methods: We conducted a systematic literature search of MEDLINE, EMBASE, Cochrane Central Register of Clinical Trials, Cochrane Database of Systematic Reviews, clinicaltrials.gov, and the National Guideline Clearinghouse databases without language restriction for studies including combinations of relevant terms. All authors independently screened the abstracts of the search results, identified articles eligible for review, and critically appraised the full-text studies. Pooled-data analyses and Kaplan-Meier survival analyses were conducted using SPSS version 16.0 software (SPSS Inc., Chicago, IL).Results: Of the 2,524 citations reviewed, the included articles consisted of 63 case reports and 10 case series reporting on 141 patients with laryngeal MMP. No clinical trials or comparative trials were found. The overall calculated prevalence of laryngeal MMP was 12.2% (95% confidence interval [CI], 11.5-12.9%) of cases of MMP or one in 10 million persons in the general population. Mean age at laryngeal MMP onset was 59.7 years (95% CI, 57.9-61.1 years), and the supraglottis was the most commonly affected site (84.8%, 95% CI, 82.5-87.2%). Distribution among genders was equivalent (P = .655). The presence of antiepiligrin autoantibodies was associated with increased laryngeal involvement (Odds ratio 7.9, 95% CI, 3.9-16.0). The overall 5-year relative survival rate was 92.4% (standard error, 8.4) with a follow-up range of 1 to 221 months. Standard medical therapy alone occasionally improved the condition; however, relapses were frequent, and 10.5% eventually required tracheostomy. Laryngeal surgical interventions seemed to be effective in severe cases.Conclusions: Laryngeal MMP is a rare condition that can be life threatening without proper treatment and frequent follow-up.