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阿司匹林加重性呼吸疾病的管理:未来何去何从?

Management of Aspirin-Exacerbated Respiratory Disease: What Does the Future Hold?

作者信息

O'Brien Erin K, Jerschow Elina, Divekar Rohit D

机构信息

Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN, USA.

Division of Allergic Diseases, Department of Medicine, Mayo Clinic, Rochester, MN, USA.

出版信息

Otolaryngol Clin North Am. 2024 Apr;57(2):265-278. doi: 10.1016/j.otc.2023.09.006. Epub 2023 Oct 11.

Abstract

Aspirin-exacerbated respiratory disease (AERD) is a subtype of chronic rhinosinusitis with polyps (CRSwNP) and asthma with higher recurrence of nasal polyps after surgery and severe asthma. Patients with CRSwNP and asthma should be screened for AERD by detailed history of aspirin/nonsteroidal anti-inflammatory drug reactions and review of medications that may mask aspirin reaction or directly by aspirin challenge. Treatment of AERD may require more intensive therapy, including endoscopic sinus surgery, daily aspirin therapy, leukotriene modifiers, or biologics.

摘要

阿司匹林加重性呼吸系统疾病(AERD)是慢性鼻-鼻窦炎伴鼻息肉(CRSwNP)和哮喘的一种亚型,术后鼻息肉复发率更高且哮喘严重。对于CRSwNP和哮喘患者,应通过详细询问阿司匹林/非甾体类抗炎药反应病史、审查可能掩盖阿司匹林反应的药物或直接进行阿司匹林激发试验来筛查AERD。AERD的治疗可能需要更强化的治疗,包括鼻内镜鼻窦手术、每日阿司匹林治疗、白三烯调节剂或生物制剂。

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