Kim Min-Hye, Jung Jae-Woo, Cho Sang-Heon, Min Kyung-Up, Kang Hye-Ryun
Department of Internal Medicine, Seoul National University College of Medicine, Seoul 110-799, Korea. ; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 110-799, Korea. ; Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul 158-710, Korea.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul 110-799, Korea. ; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 110-799, Korea. ; Department of Internal Medicine, Chung-Ang University Hospital, Seoul 156-755, Korea.
Asia Pac Allergy. 2014 Oct;4(4):222-9. doi: 10.5415/apallergy.2014.4.4.222. Epub 2014 Oct 29.
Upper respiratory diseases have been linked with lower respiratory diseases. However, the long-term effect of sinusitis on the clinical outcomes of asthma has not been fully evaluated.
The aim of this study was to investigate the impact of sinusitis on the disease progression of asthma.
Seventy-five asthmatic patients confirmed with the methacholine bronchial provocation test or bronchodilator response were included. The study patients underwent paranasal sinus x-ray upon their asthma evaluation and they visited the hospital at least 3 years or longer. We retrospectively reviewed their medical records and compared data according to the presence of comorbid sinusitis.
Among the 75 asthmatic subjects, 38 subjects (50.7%) had radiologic evidence of sinusitis. Asthmatics with sinusitis had significantly lower forced expiratory volume in 1 second (FEV1; 79.2% vs. 88.2%) and PC20 values (5.2 mg/mL vs. 8.9 mg/mL) compared to asthmatics without sinusitis at the time of diagnosis. This difference in FEV1 disappeared (82.6% vs. 87.2%) in the 3-year follow-up, although FEV1 was more variable (31.7% vs. 23.5%) and worst FEV1 was also significantly lower in patients with sinusitis compared to those without (70.9% vs. 79.0%). There were no significant differences in the number of hospital visits, acute exacerbations, and scores for the asthma control test.
Although sinusitis was associated with lower baseline lung function and higher hyperreactivity, sinusitis was not related with significant deterioration in lung function over 3 years of follow-up. Asthmatics with sinusitis showed more variability in lung function during the follow-up period. Healthcare utilization was not different except antibiotics use.
上呼吸道疾病与下呼吸道疾病有关。然而，鼻窦炎对哮喘临床结局的长期影响尚未得到充分评估。
本研究旨在探讨鼻窦炎对哮喘疾病进展的影响。
纳入75例经乙酰甲胆碱支气管激发试验或支气管扩张剂反应确诊的哮喘患者。研究患者在哮喘评估时接受鼻窦X光检查，且他们至少3年或更长时间来院就诊。我们回顾性分析了他们的病历，并根据是否合并鼻窦炎比较数据。
在75例哮喘受试者中，38例（50.7%）有鼻窦炎的影像学证据。与无鼻窦炎的哮喘患者相比，合并鼻窦炎的哮喘患者在诊断时1秒用力呼气容积（FEV1；79.2%对88.2%）和PC20值（5.2mg/mL对8.9mg/mL）显著更低。在3年随访中，FEV1的这种差异消失了（82.6%对87.2%），尽管与无鼻窦炎的患者相比，合并鼻窦炎的患者FEV1变化更大（31.7%对23.5%），且最差FEV1也显著更低（70.9%对79.0%）。在就诊次数、急性加重次数和哮喘控制测试评分方面无显著差异。
虽然鼻窦炎与较低的基线肺功能和较高的反应性相关，但在3年随访中，鼻窦炎与肺功能的显著恶化无关。合并鼻窦炎的哮喘患者在随访期间肺功能变化更大。除抗生素使用外，医疗资源利用情况无差异。
