Uhliarova B, Kopincova J, Kolomaznik M, Adamkov M, Svec M, Calkovska A
Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Bratislava, Slovakia.
Department of Otorhinolaryngology, FD Roosevelt Faculty Hospital, Banska Bystrica, Slovakia.
Clin Otolaryngol. 2015 Oct;40(5):429-36. doi: 10.1111/coa.12392.
The study was designed to determine whether there is an association between the comorbidity as atopy, bronchial asthma, aspirin intolerance and eosinophil infiltration of the upper airways, severity of the sinonasal disease and rate of revision sinus surgery in patients with nasal polyps.
One hundred and fifty patients were enrolled in the prospective study. Differences in CT score, rate of revision surgery, concentration of eotaxin and eosinophil cationic protein in nasal lavage fluid (NALF) and distribution of eosinophils in NALF and nasal tissue in patients with chronic rhinosinusitis with nasal polyps (CRSwNP), chronic rhinosinusitis without nasal polyps (CRSsNP) and control group were investigated. We focused on the relationship between presence of comorbidity (atopy, bronchial asthma and aspirin intolerance) and severity of the disease, the need of revision surgery and markers of eosinophil inflammation in upper airways in patients with CRSwNP.
Patients with CRSwNP had more severe form of the sinonasal disease, higher rate of revision FESS and significant higher presence of markers of eosinophil inflammation in NALF and nasal tissue than patients with CRSsNP (P < 0.05). Atopic and non-atopic asthma as well as aspirin sensitivity significantly more often coexisted with CRSwNP. Comorbidity did not influence eosinophil infiltration or severity of the disease in patients with CRSwNP.
Presence of comorbidity (atopy, bronchial asthma and aspirin intolerance) has no impact on severity of the disease or eosinophil content in the upper airways in patients with CRSwNP.
本研究旨在确定鼻息肉患者的特应性、支气管哮喘、阿司匹林不耐受等合并症与上呼吸道嗜酸性粒细胞浸润、鼻窦疾病严重程度及鼻窦修正手术率之间是否存在关联。
150例患者纳入前瞻性研究。研究慢性鼻窦炎伴鼻息肉（CRSwNP）、慢性鼻窦炎不伴鼻息肉（CRSsNP）患者及对照组的CT评分、修正手术率、鼻灌洗液（NALF）中嗜酸性粒细胞趋化因子和嗜酸性粒细胞阳离子蛋白浓度，以及NALF和鼻组织中嗜酸性粒细胞的分布差异。我们重点关注CRSwNP患者合并症（特应性、支气管哮喘和阿司匹林不耐受）的存在与疾病严重程度、修正手术需求及上呼吸道嗜酸性粒细胞炎症标志物之间的关系。
与CRSsNP患者相比，CRSwNP患者的鼻窦疾病形式更严重，修正功能性内镜鼻窦手术（FESS）率更高，NALF和鼻组织中嗜酸性粒细胞炎症标志物的存在显著更高（P < 0.05）。特应性和非特应性哮喘以及阿司匹林敏感性与CRSwNP共存的情况明显更常见。合并症对CRSwNP患者的嗜酸性粒细胞浸润或疾病严重程度没有影响。
合并症（特应性、支气管哮喘和阿司匹林不耐受）的存在对CRSwNP患者的疾病严重程度或上呼吸道嗜酸性粒细胞含量没有影响。
