Kaya Saltuk Buğra, Çakmak Mehmet Erdem, Damadoğlu Ebru, Karakaya Gül, Kalyoncu Ali Fuat
Division of Allergy and Clinical Immunology, Department of Chest Diseases, Hacettepe University, Faculty of Medicine, Ankara, Turkey.
Turk Thorac J. 2021 Sep;22(5):376-380. doi: 10.5152/TurkThoracJ.2021.0298.
Aspirin desensitization is recommended for patients with nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity, in whom asthma is uncontrolled despite medical treatment, and/or frequent endoscopic sinus surgery (ESS) is required due to nasal polyps. There are few studies in the literature on long-term follow-up of patients undergoing regular aspirin treatment after desensitization. This study aims to evaluate the effect of regular aspirin treatment on respiratory function, symptom control, quality of life, and the number of nasal surgeries required during a period of 12 years.
A total of 18 patients were included in the study in 2006; 11 patients were excluded and 7 patients regularly taking aspirin for 12 years were evaluated. Oral aspirin desensitization was performed at 4-6 weeks following the ESS. Patients receiving 300 mg/day aspirin were followed up in control visits every 3 months. Nasal and respiratory system examinations and pulmonary function test were performed, and all patients responded to the SF-36 Quality of Life scale during each visit.
There was no change in respiratory function parameters following the12-year aspirin treatment. There was no statistically significant improvement in the quality of life; however, the need for ESS due to the recurrence of nasal polyps decreased significantly (P = .000). At the 12-year follow-up, all symptom scores improved, but improvement in the postnasal drip score was statistically significant (P = .046).
Long-term regular treatment with aspirin at a dose of 300 mg/day in patients with N-ERD improved symptom scores, and alleviated the need for ESS due to nasal polyp recurrence.
对于非甾体抗炎药（NSAID）过敏、尽管接受了药物治疗哮喘仍未得到控制且/或因鼻息肉需要频繁进行内镜鼻窦手术（ESS）的患者，推荐进行阿司匹林脱敏治疗。关于脱敏后接受常规阿司匹林治疗的患者的长期随访，文献中的研究较少。本研究旨在评估常规阿司匹林治疗对呼吸功能、症状控制、生活质量以及12年期间所需鼻手术次数的影响。
2006年共有18例患者纳入本研究；排除11例患者，对7例规律服用阿司匹林12年的患者进行评估。在ESS后4 - 6周进行口服阿司匹林脱敏。接受300毫克/天阿司匹林治疗的患者每3个月进行一次对照随访。进行鼻和呼吸系统检查以及肺功能测试，所有患者在每次随访时均对SF - 36生活质量量表做出回应。
12年阿司匹林治疗后呼吸功能参数无变化。生活质量无统计学上的显著改善；然而，因鼻息肉复发而需要进行ESS的情况显著减少（P = .000）。在12年随访时，所有症状评分均有所改善，但鼻后滴漏评分的改善具有统计学意义（P = .046）。
对于非嗜酸性粒细胞性难治性鼻窦炎（N - ERD）患者，长期规律服用300毫克/天的阿司匹林可改善症状评分，并减轻因鼻息肉复发而进行ESS的必要性。
