Gray Stacey T, Phillips Katie M, Hoehle Lloyd P, Feng Allen L, Yamasaki Alisa, Caradonna David S, Sedaghat Ahmad R
a Department of Otolaryngology , Harvard Medical School , Boston , MA , USA.
b Department of Otolaryngology , Massachusetts Eye and Ear Infirmary , Boston , MA , USA.
Acta Otolaryngol. 2018 Feb;138(2):153-158. doi: 10.1080/00016489.2017.1380313. Epub 2017 Oct 9.
We sought to characterize the utilization pattern and factors associated with use of systemic corticosteroids for CRS.
This was a cross-sectional study of 236 participants with CRS who were prospectively recruited. Participants reported the number of CRS-related oral corticosteroid courses taken in the last year. Baseline CRS symptomatology was measured using the 22-item Sinonasal Outcome Test (SNOT-22) and SNOT-22 sleep, nasal, otologic/facial pain and emotional subdomain scores. Clinical and demographic characteristics were also collected. Association was determined between patient characteristics and oral corticosteroid use in the last year for CRS.
Sleep (p = .026), nasal (p < .001) and otologic/facial pain (p = .022) SNOT-22 subdomain scores, and nasal polyps (p = .007) were associated with CRS-related oral corticosteroid use. In study participants without polyps, past CRS-related oral corticosteroid use was associated with sleep (adjusted OR = 1.56, 95%CI: 1.01-2.40, p = .043), otologic/facial pain (adjusted OR = 1.65, 95%CI: 1.09-2.51, p = .019) and nasal subdomain scores (adjusted OR = 1.59, 95%CI: 1.01-2.51, p = .047). In study participants with polyps, past CRS-related oral corticosteroid use was only associated with the nasal subdomain score (adjusted OR = 2.20, 95%CI: 1.40-3.45, p = .001).
Past CRS-related oral corticosteroid use was associated with increased baseline severity of specific symptoms, which were different depending on the presence of polyps.
我们试图描述慢性鼻-鼻窦炎（CRS）全身用糖皮质激素的使用模式及相关因素。
这是一项对236名前瞻性招募的CRS患者进行的横断面研究。参与者报告了过去一年中与CRS相关的口服糖皮质激素疗程数。使用22项鼻鼻窦结局测试（SNOT-22）以及SNOT-22睡眠、鼻部、耳科/面部疼痛和情绪子域评分来测量基线CRS症状。还收集了临床和人口统计学特征。确定了患者特征与过去一年中CRS口服糖皮质激素使用之间的关联。
睡眠（p = 0.026）、鼻部（p < 0.001）和耳科/面部疼痛（p = 0.022）的SNOT-22子域评分以及鼻息肉（p = 0.007）与CRS相关的口服糖皮质激素使用有关。在没有息肉的研究参与者中，过去与CRS相关的口服糖皮质激素使用与睡眠（调整后的OR = 1.56，95%CI：1.01 - 2.40，p = 0.043）、耳科/面部疼痛（调整后的OR = 1.65，95%CI：1.09 - 2.51，p = 0.019）和鼻部子域评分（调整后的OR = 1.59，95%CI：1.01 - 2.51，p = 0.047）有关。在有息肉的研究参与者中，过去与CRS相关的口服糖皮质激素使用仅与鼻部子域评分有关（调整后的OR = 2.20，95%CI：1.40 - 3.45，p = 0.001）。
过去与CRS相关的口服糖皮质激素使用与特定症状的基线严重程度增加有关，这因息肉的存在与否而有所不同。
