Crampette L, Serrano E, Klossek J M, Rugina M, Rouvier P, Peynègre R, Bébéar J P, Stoll D
Hôpital Gui de Chauliac, Service ORL et CCF, 2 avenue Bertin Sans, F-34295 Montpellier, France.
Rev Laryngol Otol Rhinol (Bord). 2001;122(4):231-6.
224 patients presenting with nasal polyposis (NP) were included in a french prospective multicenter study. NP was evaluated by nasal endoscopy and computed tomography. Allergic status was documented using skin prick-tests and/or specific IgE. Pneumologic assessment included spirometry with carbamyl-choline hyper-reactivity test or beta 2 mimetic broncho-dilation test. Minimal follow up period was 1 year. 45% of the whole population were considered as asthmatic. Asthma onset occurred before and after the NP onset in respectively 45.7%, 22.3% and 32% of cases; these two conditions started simultaneously in 32% of patients. Skin prick-tests and/or specific IgE were positive in 32.5% of cases. In most of the cases (80%), patients were polysensitized to house dust mite and/or pollens and/or animal danders and/or fungi. 31% of the population had idiosyncrasy, caused by drugs in general and especially aspirin in 44% of cases. The global population could be divided in two groups according to the occurrence of previous polypectomy or not. The group "polypectomy" and the group "no polypectomy" were similar regarding the frequency, the age of onset, the course and the severity of associated asthma. Familial history (parents, children, brothers and sisters) was of great interest: 58.7% of the patients had one (or more) relative suffering from NP, 43.6% of the patients had one (or more) relative suffering from asthma and 12.2% of the patients had one (or more) relative suffering from idiosyncrasy. These results support a genetic etiology for NP.
224例患有鼻息肉(NP)的患者被纳入一项法国前瞻性多中心研究。通过鼻内镜检查和计算机断层扫描对NP进行评估。使用皮肤点刺试验和/或特异性IgE记录过敏状态。肺部评估包括使用氨甲酰胆碱高反应性试验或β2激动剂支气管扩张试验的肺功能测定。最短随访期为1年。整个人口中45%被认为患有哮喘。哮喘发作分别在NP发作之前、之后和同时发生的病例中占45.7%、22.3%和32%;这两种情况在32%的患者中同时开始。皮肤点刺试验和/或特异性IgE在32.5%的病例中呈阳性。在大多数病例(80%)中,患者对屋尘螨和/或花粉和/或动物皮屑和/或真菌多敏。31%的人群有特异反应,一般由药物引起,在44%的病例中尤其由阿司匹林引起。根据既往是否进行过息肉切除术,总体人群可分为两组。“息肉切除术”组和“未进行息肉切除术”组在相关哮喘的频率、发病年龄、病程和严重程度方面相似。家族史(父母、子女、兄弟姐妹)很值得关注:58.7%的患者有一名(或多名)亲属患有NP,43.6%的患者有一名(或多名)亲属患有哮喘,12.2%的患者有一名(或多名)亲属患有特异反应。这些结果支持NP的遗传病因。