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嗜酸性粒细胞性慢性鼻-鼻窦炎患者的肺功能

Pulmonary function in patients with eosinophilic chronic rhinosinusitis.

作者信息

Uraguchi Kensuke, Kariya Shin, Makihara Seiichiro, Okano Mitsuhiro, Haruna Takenori, Oka Aiko, Fujiwara Rumi, Noda Yohei, Nishizaki Kazunori

机构信息

Department of Otolaryngology-Head and Neck Surgery, Kagawa Rosai Hospital, Kagawa, Japan.

Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

出版信息

Auris Nasus Larynx. 2018 Jun;45(3):476-481. doi: 10.1016/j.anl.2017.07.020. Epub 2017 Aug 10.

Abstract

OBJECTIVE

There is a close relationship between upper and lower respiratory tract diseases. Chronic rhinosinusitis patients frequently have lung diseases including asthma and chronic obstructive pulmonary disease. Eosinophilic chronic rhinosinusitis is considered a refractory and intractable subtype of chronic rhinosinusitis. However, there has been no report on pulmonary function in patients with eosinophilic chronic rhinosinusitis. The purpose of this study is to examine the pulmonary function in eosinophilic chronic rhinosinusitis patients and non-eosinophilic chronic rhinosinusitis patients, and evaluate clinical factors associated with the pulmonary function of these patients.

METHODS

Pulmonary function was measured in 53 patients with eosinophilic chronic rhinosinusitis with asthma, 58 patients with eosinophilic chronic rhinosinusitis without asthma, and 30 patients with non-eosinophilic chronic rhinosinusitis. The diagnosis of chronic rhinosinusitis was based on the definition in the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) 2012. Eosinophilic chronic rhinosinusitis was diagnosed based on the Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis (JESREC) scoring system. The relationship between pulmonary function and clinical parameters was assessed. These parameters included radiographic severity of chronic rhinosinusitis, peripheral blood eosinophil percentage, serum total immunoglobulin E level, and eosinophilic infiltration in nasal polyps.

RESULTS

The pulmonary function of the patients with eosinophilic chronic rhinosinusitis was significantly affected. The eosinophilic chronic rhinosinusitis patients had more peripheral airway obstruction as compared to the patients with non-eosinophilic chronic rhinosinusitis.

CONCLUSION

Our findings indicated latent obstructive lung function changes in the eosinophilic chronic rhinosinusitis patients. The patients with eosinophilic chronic rhinosinusitis should be carefully monitored in order to detect lung diseases.

摘要

目的

上、下呼吸道疾病之间存在密切关系。慢性鼻-鼻窦炎患者常伴有肺部疾病,包括哮喘和慢性阻塞性肺疾病。嗜酸性粒细胞性慢性鼻-鼻窦炎被认为是慢性鼻-鼻窦炎的一种难治且棘手的亚型。然而,尚无关于嗜酸性粒细胞性慢性鼻-鼻窦炎患者肺功能的报道。本研究的目的是检测嗜酸性粒细胞性慢性鼻-鼻窦炎患者和非嗜酸性粒细胞性慢性鼻-鼻窦炎患者的肺功能,并评估与这些患者肺功能相关的临床因素。

方法

对53例合并哮喘的嗜酸性粒细胞性慢性鼻-鼻窦炎患者、58例不合并哮喘的嗜酸性粒细胞性慢性鼻-鼻窦炎患者和30例非嗜酸性粒细胞性慢性鼻-鼻窦炎患者进行肺功能检测。慢性鼻-鼻窦炎的诊断基于2012年《欧洲鼻窦炎和鼻息肉立场文件》(EPOS)中的定义。嗜酸性粒细胞性慢性鼻-鼻窦炎根据日本难治性嗜酸性粒细胞性慢性鼻-鼻窦炎流行病学调查(JESREC)评分系统进行诊断。评估肺功能与临床参数之间的关系。这些参数包括慢性鼻-鼻窦炎的影像学严重程度、外周血嗜酸性粒细胞百分比、血清总免疫球蛋白E水平以及鼻息肉中的嗜酸性粒细胞浸润情况。

结果

嗜酸性粒细胞性慢性鼻-鼻窦炎患者的肺功能受到显著影响。与非嗜酸性粒细胞性慢性鼻-鼻窦炎患者相比,嗜酸性粒细胞性慢性鼻-鼻窦炎患者存在更多的外周气道阻塞。

结论

我们的研究结果表明嗜酸性粒细胞性慢性鼻-鼻窦炎患者存在潜在的阻塞性肺功能改变。应对嗜酸性粒细胞性慢性鼻-鼻窦炎患者进行密切监测,以便发现肺部疾病。

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