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变应性鼻炎与喉部病理学:真实世界证据

Allergic Rhinitis and Laryngeal Pathology: Real-World Evidence.

作者信息

Wang Yun-Ting, Chang Geng-He, Yang Yao-Hsu, Liu Chia-Yen, Tsai Yao-Te, Hsu Cheng-Ming, Lee Yi-Chan, Lee Li-Ang, Yang Pei-Rung, Tsai Ming-Shao, Li Hsueh-Yu

机构信息

Department of Otolaryngology-Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan.

College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.

出版信息

Healthcare (Basel). 2021 Jan 3;9(1):36. doi: 10.3390/healthcare9010036.

Abstract

Allergic rhinitis (AR) is correlated with diseases including allergic laryngitis, chronic obstructive pulmonary disease (COPD), asthma, and chronic rhinosinusitis (CRS). The unified airway model suggests that inflammation can spread in both lower and upper respiratory tracts. Moreover, some voice problems-laryngeal edema, dysphonia, and vocal nodules-have been associated with AR. We examined the association between AR and laryngeal pathology. We investigated 51,618 patients with AR between 1 January 1997 and 31 December 2013, along with 206,472 patients without AR matched based on age, gender, urbanization level, and socioeconomic status at a 1:4 ratio. We followed patients up to the end of 2013 or their death. The occurrence of laryngeal pathology was the primary outcome. Individuals with AR had a 2.43 times higher risk of laryngeal pathology than the comparison cohort group (adjusted HR: 2.43, 95% CI: 2.36-2.50, < 0.001). Patients diagnosed as having AR exhibited higher comorbidity rates, including of asthma, COPD, CRS, gastroesophageal reflux disease, and nasal septum deviation, than those of the comparison cohort. Our results strongly indicate that AR is an independent risk factor for laryngeal pathology. Therefore, when treating AR and voice problems, physicians should be attuned to possible laryngeal pathology.

摘要

变应性鼻炎(AR)与包括变应性喉炎、慢性阻塞性肺疾病(COPD)、哮喘和慢性鼻-鼻窦炎(CRS)在内的疾病相关。统一气道模型表明炎症可在上下呼吸道扩散。此外,一些嗓音问题——喉部水肿、发声障碍和声带小结——已与AR相关。我们研究了AR与喉部病理之间的关联。我们调查了1997年1月1日至2013年12月31日期间的51618例AR患者,以及按年龄、性别、城市化水平和社会经济地位以1:4比例匹配的206472例非AR患者。我们对患者进行随访至2013年底或其死亡。喉部病理的发生是主要结局。AR患者发生喉部病理的风险比对照组高2.43倍(校正后HR:2.43,95%CI:2.36 - 2.50,P < 0.001)。被诊断为AR的患者比对照组表现出更高的合并症发生率,包括哮喘、COPD、CRS、胃食管反流病和鼻中隔偏曲。我们的结果强烈表明AR是喉部病理的独立危险因素。因此,在治疗AR和嗓音问题时,医生应注意可能存在的喉部病理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/083a/7824592/1b56a47d4fc1/healthcare-09-00036-g001.jpg

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