Brook Christopher D, Maxfield Alice Z, Stankovic Konstantina, Metson Ralph B
Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, USA.
Otolaryngol Head Neck Surg. 2016 Dec;155(6):1046-1052. doi: 10.1177/0194599816663924. Epub 2016 Aug 23.
OBJECTIVE/HYPOTHESIS: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) have been shown to suppress expression of periostin, a matricellular protein that is markedly elevated in nasal polyp tissue. The purpose of this study was to determine whether use of these antihypertensive agents affects the time to revision sinus surgery in patients with polyp regrowth.
Case series with chart review.
Academic medical center.
Records were reviewed for 330 patients who underwent ≥2 operations for chronic sinusitis with nasal polyps from April 1987 through August 2015. The time between surgical interventions was compared with patient demographics and clinical characteristics, including use of ACEIs and ARBs.
Sixty patients were taking ACEIs or ARBs during the study period, of which 32 had concurrent asthma. The mean interval between polyp operations was 61.0 ± 45.2 months (range, 2-228.6 months). Among patients with asthma (n = 197), the mean time to revision surgery was prolonged by >2 years for those taking ACEIs or ARBs (81.0 vs 54.5 months, P = .006). A similar impact on time to revision surgery was not observed for nonasthmatics taking these medications (61.0 vs 65.2 months, P = .655).
Use of ACEIs and ARBs is associated with an increased time to revision sinus surgery among patients with concurrent nasal polyps and asthma. A possible mechanism of this observed effect is suppression of periostin expression through inhibition of the angiotensin pathway.
目的/假设：血管紧张素转换酶抑制剂（ACEIs）和血管紧张素受体阻滞剂（ARBs）已被证明可抑制骨膜蛋白的表达，骨膜蛋白是一种基质细胞蛋白，在鼻息肉组织中显著升高。本研究的目的是确定使用这些抗高血压药物是否会影响息肉复发患者再次鼻窦手术的时间。
病例系列研究并进行病历回顾。
学术医疗中心。
回顾了1987年4月至2015年8月期间因慢性鼻窦炎伴鼻息肉接受≥2次手术的330例患者的记录。将手术干预之间的时间与患者人口统计学和临床特征进行比较，包括ACEIs和ARBs的使用情况。
60例患者在研究期间服用ACEIs或ARBs，其中32例同时患有哮喘。息肉手术之间的平均间隔时间为61.0±45.2个月（范围为2 - 228.6个月）。在患有哮喘的患者（n = 197）中，服用ACEIs或ARBs的患者再次手术的平均时间延长了2年以上（81.0对54.5个月，P = .006）。对于服用这些药物的非哮喘患者，未观察到对再次手术时间有类似影响（61.0对65.2个月，P = .655）。
ACEIs和ARBs的使用与合并鼻息肉和哮喘患者再次鼻窦手术的时间延长有关。这种观察到的效应的可能机制是通过抑制血管紧张素途径来抑制骨膜蛋白的表达。
