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• Vol.42 No.3
• CLINICA NEUROL, 42: 240−242, 2002
• Vol.42 No.3 contents

Brief Clinical Note

ACE inhibitors and its usefulness in the prevention of aspiration pneumonia in chronic cerebrovascular disease patients with asymptomatic swallowing dysfunction

Seiji Shibuya, M. D. , Makoto Murahashi, M. D. , Masahiko Inoue, M. D. , Takahiro Jimi, M. D. and Yoshihiro Wakayama, M. D.

Department of Neurology, Showa University Fujigaoka Hospital

The double contrast pharyngogram by use of computed radiography (DCP-CR) has been found to be useful in detection of asymptomatic swallowing dysfunction. Following the DCP-CR examination, we investigated the incidence of aspiration pneumonia in 143 patients with chronic cerebrovascular disease (CVD) for 3 years and the effects of ACE inhibitors on the prevention of pneumonia. Aspiration pneumonia occured in 29 out of 143 patients, and more frequently in the elderly chronic CVD patients with multiple brain lesions. Aspiration pneumonia was confirmed in 26 out of 85 patients (30.6%) with abnormal barium adhesion to the pharyngeal wall on the double contrast pharyngogram image by DCP-CR; whereas pneumonia occured in 3 out of 58 patients (5.2%) with normal findings of DCP-CR pharyngogram. Among chronic CVD patients with abnormal findings of DCP-CR pharyngogram, the incidence of aspiration pneumonia was significantly lower in the patients treated with ACE inhibitors than in those treated with other antihypertensive agents or without antihypertensive agents (χ ² value=7.163, p<0.05). Accordingly, ACE inhibitors may prevent the aspiration pneumonia and reduce the incidence of aspiration pneumonia in the chronic CVD patients with abnormal DCP-CR pharyngogram images.

(CLINICA NEUROL, 42: 240−242, 2002)
key words: computed radiography, double contrast pharyngogram, chronic cerebrovascular disease, aspiration pneumonia, ACE inhibitors

(Received: 7-Feb-02)