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阿司匹林加重性呼吸系统疾病:患病率、诊断、治疗及未来考量

Aspirin-exacerbated respiratory disease: Prevalence, diagnosis, treatment, and considerations for the future.

作者信息

Kennedy Joshua L, Stoner Ashley N, Borish Larry

机构信息

Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.

出版信息

Am J Rhinol Allergy. 2016 Nov 1;30(6):407-413. doi: 10.2500/ajra.2016.30.4370.

Abstract

Aspirin-exacerbated respiratory disease (AERD) is a late onset condition characterized by the Samter triad (aspirin sensitivity [as well as sensitivity to any nonselective cyclooxygenase inhibitor], nasal polyps, asthma) and additional features, including eosinophilic chronic rhinosinusitis, hypereosinophilia, anosmia, frequent absence of atopy, and, intolerance to ingestion of red wine and other alcoholic beverages. The diagnosis is rare, and, because of this, it is also often missed by physicians. However, it is highly overexpressed in patients with severe asthma (and severe chronic rhinosinusitis with nasal polyps), which makes its recognition essential. For this review, we considered mechanisms involved in the pathogenesis of this disease and discussed the clinical symptoms of AERD. We also discussed the role of aspirin desensitization in the treatment of AERD. Also, we considered medications (e.g, leukotriene modifiers) and surgical interventions that have a role in the treatment of AERD.

摘要

阿司匹林诱发的呼吸道疾病(AERD)是一种迟发性疾病,其特征为桑特三联征(阿司匹林敏感性[以及对任何非选择性环氧化酶抑制剂的敏感性]、鼻息肉、哮喘)以及其他特征,包括嗜酸性粒细胞性慢性鼻-鼻窦炎、嗜酸性粒细胞增多、嗅觉丧失、常无特应性,以及对饮用红酒和其他酒精饮料不耐受。该诊断较为罕见,正因为如此,医生也常常漏诊。然而,它在重度哮喘患者(以及伴有鼻息肉的重度慢性鼻-鼻窦炎患者)中高度表达,这使得对其识别至关重要。在本综述中,我们探讨了该疾病发病机制中涉及的机制,并讨论了AERD的临床症状。我们还讨论了阿司匹林脱敏在AERD治疗中的作用。此外,我们考虑了在AERD治疗中发挥作用的药物(如白三烯调节剂)和手术干预措施。

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