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全身性抗生素和皮质类固醇用于慢性鼻窦炎与生活质量之间的关联。

Association between systemic antibiotic and corticosteroid use for chronic rhinosinusitis and quality of life.

作者信息

Yamasaki Alisa, Hoehle Lloyd P, Phillips Katie M, Feng Allen L, Campbell Adam P, Caradonna David S, Gray Stacey T, Sedaghat Ahmad R

机构信息

Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, U.S.A.

Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A.

出版信息

Laryngoscope. 2018 Jan;128(1):37-42. doi: 10.1002/lary.26778. Epub 2017 Jul 21.

Abstract

OBJECTIVE

We sought to establish the significance of querying chronic rhinosinusitis (CRS) patients about their past CRS-related oral antibiotic and corticosteroid usage by determining the association between these metrics and patients' quality of life (QoL).

STUDY DESIGN

Cross-sectional study.

METHODS

A total of 157 patients with CRS were prospectively recruited. CRS-specific QoL was measured using the 22-item Sinonasal Outcome Test (SNOT-22). General health-related QoL was measured using the EuroQoL five-dimensional questionnaire visual analog scale. Associations were sought between these measures of QoL and frequency of CRS-related oral antibiotic and corticosteroid usage reported by the participants in the prior 3 and 12 months.

RESULTS

More frequent antibiotic and corticosteroid use was significantly associated with worse CRS-specific and general health-related QoL, whether querying medication use over the prior 3 months or over the prior 12 months (P < 0.001 in all cases). The effect size of CRS-related antibiotic use during the prior 3 months on CRS-specific QoL (SNOT-22 score) was significantly greater than for use during the prior 12 months. However, there was no other statistically significant difference in effect size for association between QoL and CRS-related antibiotic or corticosteroid use in the prior 3 months versus prior 12 months. These results were independent of the presence or absence of polyps.

CONCLUSION

More frequent past CRS-related oral antibiotic and corticosteroid use, regardless of time period queried (3 months or 12 months) is associated with significant decrease in CRS-specific and general health-related QoL. CRS-related systemic medication use is an important indicator of CRS patients' QOL that easily can be queried and utilized in both clinical and research settings.

LEVEL OF EVIDENCE

2c. Laryngoscope, 128:37-42, 2018.

摘要

目的

通过确定慢性鼻窦炎(CRS)患者过去与CRS相关的口服抗生素和皮质类固醇使用情况与患者生活质量(QoL)之间的关联,探讨询问CRS患者这些用药情况的意义。

研究设计

横断面研究。

方法

前瞻性招募了157例CRS患者。使用22项鼻鼻窦结局测试(SNOT-22)测量CRS特异性生活质量。使用欧洲五维健康量表视觉模拟量表测量总体健康相关生活质量。研究这些生活质量指标与参与者在前3个月和12个月报告的与CRS相关的口服抗生素和皮质类固醇使用频率之间的关联。

结果

无论询问的是前3个月还是前12个月的用药情况,更频繁地使用抗生素和皮质类固醇都与更差的CRS特异性和总体健康相关生活质量显著相关(所有情况下P < 0.001)。前3个月与CRS相关的抗生素使用对CRS特异性生活质量(SNOT-22评分)的影响大小显著大于前12个月的使用。然而,在前3个月与前12个月中,生活质量与CRS相关抗生素或皮质类固醇使用之间关联的效应大小没有其他统计学上的显著差异。这些结果与息肉的有无无关。

结论

过去更频繁地使用与CRS相关的口服抗生素和皮质类固醇,无论询问的时间段是3个月还是12个月,都与CRS特异性和总体健康相关生活质量的显著下降有关。与CRS相关的全身用药情况是CRS患者生活质量的一个重要指标,在临床和研究环境中都很容易询问和利用。

证据级别

2c。《喉镜》,2018年,第128卷,第37 - 42页。

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