Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan.
Department of Otorhinolaryngology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Int Forum Allergy Rhinol. 2016 Dec;6(12):1284-1293. doi: 10.1002/alr.21813. Epub 2016 Jun 29.
Few studies have investigated the relationship between asthma and chronic rhinosinusitis (CRS). The present study investigated the association between asthma and the risk of CRS in a large national sample.
Patients newly diagnosed with asthma (International Classification of Diseases, Ninth Revision [ICD-9], Clinical Modification code 493) between 2000 and 2008 were identified from the Taiwan National Health Insurance Research Database. The cases were compared with sex-, age-, residence-, and insurance premium-matched controls, and both groups were followed until the end of 2009 for incidences of CRS with or without nasal polyps (CRSwNP or CRSsNP, respectively). Competing risk-adjusted Cox regression analyses were performed after adjustment for sex, age, residence, insurance premium, steroid use, hyperlipidemia, diabetes, hypertension, coronary artery disease, Charlson comorbidity index score, and mortality. We also performed a case-control study to determine the association between asthma and CRS.
The cohort study analysis examined 81,462 patients with a mean ± standard deviation (SD) follow-up period of 5.8 ± 2.4 years. Asthma was an independent predictor of CRSsNP (hazard ratio = 2.58; 95% confidence interval [CI], 2.20 to 3.03; p < 0.001) in the fully adjusted models. In the case-control analysis, both CRSwNP and CRSsNP were associated with asthma in the fully adjusted models.
Asthma was associated with increased risks of CRSwNP and CRSsNP, independent of several potential confounding factors.
鲜有研究调查哮喘与慢性鼻-鼻窦炎(CRS)之间的关系。本研究在一个大型全国样本中调查了哮喘与 CRS 风险之间的关联。
从台湾全民健康保险研究数据库中确定 2000 年至 2008 年间新诊断为哮喘(国际疾病分类,第九修订版[ICD-9],临床修正码 493)的患者。将这些病例与性别、年龄、居住地和保险费匹配的对照进行比较,两组均随访至 2009 年底,以确定有无鼻息肉(分别为 CRSwNP 或 CRSsNP)的 CRS 发病率。在调整性别、年龄、居住地、保险费、类固醇使用、高血脂症、糖尿病、高血压、冠心病、Charlson 合并症指数评分和死亡率后,进行竞争风险调整的 Cox 回归分析。我们还进行了病例对照研究,以确定哮喘与 CRS 之间的关联。
队列研究分析共纳入 81462 例患者,平均随访时间为 5.8±2.4 年。在完全调整模型中,哮喘是 CRSsNP 的独立预测因素(风险比=2.58;95%置信区间[CI],2.20 至 3.03;p<0.001)。在病例对照分析中,CRSwNP 和 CRSsNP 均与哮喘在完全调整模型中相关。
哮喘与 CRSwNP 和 CRSsNP 的风险增加相关,独立于多种潜在的混杂因素。