Banerji Aleena, Piccirillo Jay F, Thawley Stanley E, Levitt Robert G, Schechtman Kenneth B, Kramper Maggie A, Hamilos Daniel L
Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Am J Rhinol. 2007 Jan-Feb;21(1):19-26. doi: 10.2500/ajr.2007.21.2979.
Recent studies suggest chronic rhinosinusitis without nasal polyposis (CRSsNP) and CRS with nasal polyposis (CRScNP) represent distinct pathological entities. The aim of this study was to determine whether patients with CRSsNP, CRScNP, and polypoid CRS could be distinguished by clinical features, radiologic extent of disease or use of medications.
New patients with CRS (n = 126) were enrolled in a prospective outcomes study. Rhinoscopic evaluation was used to classify patients. The relationship between disease phenotype and clinical parameters was examined.
Facial pain/pressure/headache was more prevalent in CRSsNP than CRScNP (p = 0.01). Nasal obstruction and hyposmia/ anosmia were more prevalent in CRScNP than CRSsNP (p = 0.025 and 0.01, respectively). Intermediate symptom prevalence was found in polypoid CRS. Multivariate analysis confirmed that prior surgery, CT scan score, and male gender were independent predictors of polyp/polypoid phenotype. Allergic status was unrelated to CRS classification. Medication use was higher in CRScNP patients than in CRSsNP patients.
Compared with CRSsNP, patients with CRScNP have a greater burden of symptoms, more prior surgery, higher CT scan scores, and greater use of medications.
近期研究表明,不伴有鼻息肉的慢性鼻-鼻窦炎(CRSsNP)和伴有鼻息肉的慢性鼻-鼻窦炎(CRScNP)代表不同的病理实体。本研究的目的是确定CRSsNP、CRScNP和息肉样慢性鼻-鼻窦炎患者是否可通过临床特征、疾病的放射学范围或药物使用情况加以区分。
新诊断的慢性鼻-鼻窦炎患者(n = 126)纳入一项前瞻性预后研究。采用鼻内镜评估对患者进行分类。研究疾病表型与临床参数之间的关系。
面部疼痛/压迫感/头痛在CRSsNP中比CRScNP中更常见(p = 0.01)。鼻塞和嗅觉减退/嗅觉丧失在CRScNP中比CRSsNP中更常见(分别为p = 0.025和0.01)。息肉样慢性鼻-鼻窦炎的症状发生率处于中间水平。多因素分析证实,既往手术史、CT扫描评分和男性性别是息肉/息肉样表型的独立预测因素。过敏状态与慢性鼻-鼻窦炎的分类无关。CRScNP患者的药物使用比CRSsNP患者更多。
与CRSsNP患者相比,CRScNP患者的症状负担更重,既往手术史更多,CT扫描评分更高,药物使用更多。