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囊性纤维化患者慢性鼻-鼻窦炎的医学干预措施。

Medical interventions for chronic rhinosinusitis in cystic fibrosis.

作者信息

Karanth Tulasi Kota, Karanth Veena Kota Laxminarayan Kl, Ward Bryan K, Woodworth Bradford A, Karanth Laxminarayan

机构信息

Kasturba Medical College, Manipal University, Manipal, Karnataka, India, 576104.

出版信息

Cochrane Database Syst Rev. 2019 Oct 23;10(10):CD012979. doi: 10.1002/14651858.CD012979.pub2.

Abstract

BACKGROUND

Chronic rhinosinusitis frequently occurs in people with cystic fibrosis. Several medical interventions are available for treating chronic rhinosinusitis in people with cystic fibrosis; for example, different concentrations of nasal saline irrigations, topical or oral corticosteroids, antibiotics - including nebulized antibiotics, dornase alfa and modulators of the cystic fibrosis transmembrane conductance regulator (CFTR) (such as lumacaftor, ivacaftor or tezacaftor). However, the efficacy of these interventions is unclear.

OBJECTIVES

The objective of this review is to compare the effects of different medical interventions in people diagnosed with cystic fibrosis and chronic rhinosinusitis.

SEARCH METHODS

We searched the Cochrane Cystic Fibrosis Trials Register, compiled from electronic database searches and hand searching of journals and conference abstract books. Date of last search of trials register: 22 May 2019.We also searched ongoing trials databases, other medical databases and the reference lists of relevant articles and reviews. Date of latest additional searches: 20 May 2019.

SELECTION CRITERIA

Randomized and quasi-randomized trials of different medical interventions compared to each other or to no intervention or to placebo.

DATA COLLECTION AND ANALYSIS

Two review authors independently assessed trials identified for potential inclusion in the review. We planned to conduct data collection and analysis in accordance with Cochrane methods and to independently rate the quality of the evidence for each outcome using the GRADE guidelines.

MAIN RESULTS

We identified no trials that met the pre-defined inclusion criteria. The searches identified 47 trials, none of which were eligible for inclusion in the current version of this review.

AUTHORS' CONCLUSIONS: We identified no eligible trials assessing the medical interventions in people with cystic fibrosis and chronic rhinosinusitis. High-quality trials are needed which should assess the efficacy of different treatment options detailed above for managing chronic rhinosinusitis, preventing pulmonary exacerbations and improving quality of life in people with cystic fibrosis.

摘要

背景

慢性鼻-鼻窦炎在囊性纤维化患者中经常发生。有几种医学干预措施可用于治疗囊性纤维化患者的慢性鼻-鼻窦炎;例如,不同浓度的鼻腔盐水冲洗、局部或口服皮质类固醇、抗生素(包括雾化抗生素)、重组人脱氧核糖核酸酶α以及囊性纤维化跨膜传导调节因子(CFTR)调节剂(如鲁马卡托、依伐卡托或替扎卡托)。然而,这些干预措施的疗效尚不清楚。

目的

本综述的目的是比较不同医学干预措施对诊断为囊性纤维化和慢性鼻-鼻窦炎患者的影响。

检索方法

我们检索了Cochrane囊性纤维化试验注册库,该注册库通过电子数据库检索以及对期刊和会议摘要书籍的手工检索汇编而成。试验注册库的最后检索日期:2019年5月22日。我们还检索了正在进行的试验数据库、其他医学数据库以及相关文章和综述的参考文献列表。最新补充检索日期:2019年5月20日。

选择标准

不同医学干预措施相互比较、与无干预或安慰剂比较的随机和半随机试验。

数据收集与分析

两位综述作者独立评估确定可能纳入本综述的试验。我们计划按照Cochrane方法进行数据收集和分析,并使用GRADE指南独立评估每个结局的证据质量。

主要结果

我们未识别出符合预定义纳入标准的试验。检索共识别出47项试验,其中无一符合纳入本综述当前版本的条件。

作者结论

我们未识别出评估囊性纤维化和慢性鼻-鼻窦炎患者医学干预措施的合格试验。需要高质量的试验来评估上述不同治疗方案对管理囊性纤维化患者慢性鼻-鼻窦炎、预防肺部加重以及改善生活质量的疗效。

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本文引用的文献

1
Tezacaftor for the treatment of cystic fibrosis.Tezacaftor 治疗囊性纤维化。
Expert Rev Respir Med. 2018 Sep;12(9):725-732. doi: 10.1080/17476348.2018.1507741. Epub 2018 Aug 9.
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Clinical chronic rhinosinusitis outcomes in pediatric patients with cystic fibrosis.囊性纤维化儿科患者的临床慢性鼻-鼻窦炎转归
Laryngoscope Investig Otolaryngol. 2017 May 31;2(5):276-280. doi: 10.1002/lio2.78. eCollection 2017 Oct.
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Microbiology of chronic rhinosinusitis.慢性鼻-鼻窦炎的微生物学
Eur J Clin Microbiol Infect Dis. 2016 Jul;35(7):1059-68. doi: 10.1007/s10096-016-2640-x. Epub 2016 Apr 16.

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