Lin Yu-Hsuan, Chang Ting-Shou, Yao Yi-Chien, Li Ying-Chun
From the Department of Otolaryngology, Head and Neck surgery, Kaohsiung Veterans General Hospital, Kaohsiung (Y-HL, T-SC); Department of Otolaryngology, Head and Neck surgery, National Defense Medical Center, Taipei (Y-HL, T-SC); Institute of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan (T-SC); and Institute of Health Care Management, National Sun Yat-sen University, Kaohsiung (Y-CY, Y-CL).
Medicine (Baltimore). 2015 Sep;94(39):e1642. doi: 10.1097/MD.0000000000001642.
Although gastroesophageal reflux disease (GERD) has been reported to coexist with chronic rhinosinusitis (CRS), it remains controversial whether it increases risk of CRS in adults. This study accesses risk of CRS in adults with newly diagnosed GERD. We identified 15,807 adult patients with newly diagnosed GERD from Taiwan's National Health Insurance Research Database for January 1, 2006 to December 31, 2009. We also randomly selected 47,421 subjects without this disease and matched them with patients by age, sex, index year, and comorbidity to create a control cohort. A Cox proportional hazards model was conducted to estimate the development of CRS, including CRS without nasal polyps and CRS with nasal polyps. Subjects were followed for a median of 2.12 years. In total, CRS developed in 964 (1.52%) of the subjects: 406 patients with GERD (2.57%) and 558 without it (1.18%). After adjustment, those with GERD were found to have a 2.36 times greater risk of CRS (95% confidence interval = 2.08-2.68; P < .001). Risk of this CRS without nasal polyps was higher than the disease with polyps (adjusted hazard ratio: 2.48 vs 1.85). The individuals with GERD in this study were at significantly greater risk of CRS, most often without nasal polyps.
尽管有报道称胃食管反流病(GERD)与慢性鼻-鼻窦炎(CRS)共存,但GERD是否会增加成人患CRS的风险仍存在争议。本研究探讨新诊断为GERD的成人患CRS的风险。我们从台湾国民健康保险研究数据库中识别出2006年1月1日至2009年12月31日期间新诊断为GERD的15807例成年患者。我们还随机选择了47421名未患此病的受试者,并根据年龄、性别、索引年份和合并症与患者进行匹配,以创建一个对照队列。采用Cox比例风险模型来估计CRS的发生情况,包括无鼻息肉的CRS和有鼻息肉的CRS。受试者的随访时间中位数为2.12年。总共有964名(1.52%)受试者发生了CRS:406例GERD患者(2.57%)和558例非GERD患者(1.18%)。经过调整后,发现患GERD的患者发生CRS的风险高2.36倍(95%置信区间=2.08-2.68;P<.001)。无鼻息肉的CRS风险高于有鼻息肉的疾病(调整后的风险比:2.48对1.85)。本研究中患GERD的个体发生CRS的风险显著更高,最常见的是无鼻息肉的情况。