Marcos Sol, Botella Luisa María, Albiñana Virginia, Arbia Agustina, de Rosales Anna María
Otorrhinolaringology Department, Hospital Universitario Fundación Alcorcón, 28922 Madrid, Spain.
CIBER Rare Diseases Unit 707, Centro de Investigaciones Biológicas Margarita Salas, CSIC, 28040 Madrid, Spain.
J Clin Med. 2021 Aug 27;10(17):3845. doi: 10.3390/jcm10173845.
Epistaxis is the most prevalent clinical symptom in Hereditary Haemorrhagic Telangiectasia (HHT), causing anaemia and decreasing the quality of life (QOL). Since 2013, in Hospital Universitario Fundación Alcorcón, more than 150 HHT patients have been treated by nose sclerotherapy on demand. This study shows the results of 105 patients treated with sclerotherapy between 2017 and 2019. HHT-ESS (epistaxis severity score) was used to measure the severity and frequency of epistaxis. QOL was determined before and after treatment by EuroQol-5D (EQ-5D) and the visual analogue scale (VAS) on the health condition. According to HHT-ESS before treatment, 22 patients presented mild, 35 moderate, and 47 severe epistaxes. Sclerotherapy significantly decreased the frequency and severity of epistaxis, with a significant drop of HHT-ESS in 4.6 points, from 6.23 ± 2.3 to 1.64 ± 1.6. Furthermore, the QOL significantly improved, the EQ-5D scale raised from 0.7 ± 0.26 pre- to 0.92 ± 0.16 post-treatment ( < 0.05). Additionally, VAS mean value showed a significant increase from 4.38 ± 2.4 to 8.35 ± 1.2. The QOL improvement was correlated with the ESS decrease. In conclusion, this study shows that on-demand sclerotherapy at the office significantly reduces HHT epistaxis as well as improved the patients' QOL.
鼻出血是遗传性出血性毛细血管扩张症（HHT）最常见的临床症状，可导致贫血并降低生活质量（QOL）。自2013年以来，在阿尔科孔基金会大学医院，已有150多名HHT患者接受了按需鼻硬化治疗。本研究展示了2017年至2019年间105例接受硬化治疗患者的结果。采用HHT-ESS（鼻出血严重程度评分）来衡量鼻出血的严重程度和频率。通过欧洲五维健康量表（EQ-5D）和健康状况视觉模拟量表（VAS）在治疗前后测定生活质量。根据治疗前的HHT-ESS，22例患者表现为轻度鼻出血，35例为中度，47例为重度。硬化治疗显著降低了鼻出血的频率和严重程度，HHT-ESS显著下降4.6分，从6.23±2.3降至1.64±1.6。此外，生活质量显著改善，EQ-5D量表从治疗前的0.7±0.26提高到治疗后的0.92±0.16（P<0.05）。此外，VAS平均值从4.38±2.4显著提高到8.35±1.2。生活质量的改善与ESS的降低相关。总之，本研究表明，门诊按需硬化治疗可显著减少HHT鼻出血，并改善患者的生活质量。
