Bohnhorst Idar, Jawad Samir, Lange Bibi, Kjeldsen Jens, Hansen Jane M, Kjeldsen Anette D
University of Southern Denmark, Odense, Denmark.
Am J Rhinol Allergy. 2015 May-Jun;29(3):e70-4. doi: 10.2500/ajra.2015.29.4167.
An increased coexistence of gastroesophageal reflux disease (GERD) and chronic rhinosinusitis (CRS) has been reported in epidemiologic and register studies, and reflux has been shown more frequently in patients with CRS in studies using esophagus pH manometry compared to participants without CRS. A discussion is ongoing about whether there might be an association between these two diseases and, if so, whether the association is causal.
The purpose of this study was to clinically investigate the prevalence and symptom severity scores of CRS among patients with GERD. The results were compared with those of a randomly assigned control group from the general Danish population.
In this case-control study, 82 patients with GERD were examined for CRS using the European Position Paper on Rhinosinusitis and Nasal Polyps criteria, which combine patient history and anterior/posterior rhinoscopy results. Sinonasal-related quality of life was assessed by using the Sino-Nasal Outcome Test 22 (SNOT-22). These results were compared with those of a population-based control group examined for CRS in the same way.
The prevalence of CRS among patients with GERD was 20.7% (95% confidence interval [CI], 12.0%-29.5%), significantly higher than the CRS prevalence of 8.5% (95% CI, 6.8%-10.2%) in the background population. Patients with GERD and CRS had an average SNOT-22 score of 43.8, whereas patients with CRS from the background population scored, on average, 28.1. Having GERD increased the mean SNOT-22 score in patients with CRS by 15.7 (95% CI, 6.5-24.9).
The results of this study provide additional evidence of an association between GERD and CRS and indicate that GERD may play a role in the development of CRS. The results also show that sinonasal-related quality of life is decreased in patients with CRS who also suffer from GERD.
流行病学和登记研究报告显示，胃食管反流病（GERD）与慢性鼻-鼻窦炎（CRS）共存的情况增多，并且与无CRS的参与者相比，在使用食管pH测压法的研究中，CRS患者的反流情况更为常见。关于这两种疾病之间是否可能存在关联，以及如果存在关联，这种关联是否为因果关系，目前仍在讨论中。
本研究的目的是临床调查GERD患者中CRS的患病率和症状严重程度评分。将结果与来自丹麦普通人群的随机分配对照组的结果进行比较。
在这项病例对照研究中，根据《欧洲鼻窦炎和鼻息肉立场文件》标准，结合患者病史和前后鼻镜检查结果，对82例GERD患者进行CRS检查。使用鼻窦结局测试22（SNOT-22）评估鼻窦相关生活质量。将这些结果与以同样方式检查CRS的基于人群的对照组的结果进行比较。
GERD患者中CRS的患病率为20.7%（95%置信区间[CI]，12.0%-29.5%），显著高于背景人群中8.5%（95%CI，6.8%-10.2%）的CRS患病率。GERD和CRS患者的SNOT-22平均评分为43.8，而背景人群中的CRS患者平均评分为28.1。患有GERD使CRS患者的SNOT-22平均评分增加了15.7（95%CI，6.5-24.9）。
本研究结果为GERD与CRS之间的关联提供了更多证据，并表明GERD可能在CRS的发展中起作用。结果还表明，同时患有GERD的CRS患者的鼻窦相关生活质量下降。
