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成人慢性鼻-鼻窦炎与反流性疾病的相关性:系统评价和荟萃分析。

Association Between Chronic Rhinosinusitis and Reflux Diseases in Adults: A Systematic Review and Meta-Analysis.

机构信息

Department of Otorhinolaryngology Head & Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Department of Otorhinolaryngology Head & Neck surgery, College of Medicine, University of Jeddah, Jeddah, Saudi Arabia.

出版信息

Am J Rhinol Allergy. 2024 Jan;38(1):47-59. doi: 10.1177/19458924231210028. Epub 2023 Oct 31.


DOI:10.1177/19458924231210028
PMID:37908086
Abstract

BACKGROUND: Over the last few decades, reflux diseases, such as laryngopharyngeal reflux (LPR) and gastroesophageal reflux disease (GERD), have been identified as significant contributors to inflammatory upper aerodigestive tract diseases. Establishing a direct relationship between reflux disease and chronic rhinosinusitis (CRS) is challenging due to the high prevalence of both diseases and their potential for independent coexistence. OBJECTIVE: The purpose of this study is to review the existing literature and evaluate the evidence of an association between reflux diseases and CRS. METHODS: A comprehensive electronic search was conducted across multiple databases to identify all studies that investigated the relationship between LPR, GERD, and CRS from January 1, 1950, to June 16, 2022. Only studies with English manuscripts involving adult populations were included, while case series, case reports, and in vitro studies were excluded. The risk of bias was evaluated using The Newcastle-Ottawa Scale for case-control studies and the NIH quality assessment tool for observational cohort and cross-sectional studies. RESULTS: The search strategy yielded a total of 427 articles, out of which 25 studies examined the correlation between reflux diseases and CRS. The meta-analysis indicated a significant association between the presence of GERD and CRS compared to control groups ( < .001; CI 3.56 [2.25, 5.65]), as well as significantly higher pH values and pepsin detection in CRS patients when compared to healthy individuals ( = .003). Furthermore, all studies that evaluated proton pump inhibitor (PPI) therapy in CRS patients reported positive outcomes, with 93% of CRS patients showing improvement on PPIs. CONCLUSION: The existing literature provides suggestive evidence of an association between reflux diseases and CRS, with regards to both prevalence and treatment. Nonetheless, further studies are required to confirm this relationship.

摘要

背景:在过去的几十年中,反流疾病(如喉咽反流病和胃食管反流病)已被确定为上呼吸道炎症性疾病的重要致病因素。由于这两种疾病的高患病率及其独立共存的可能性,确定反流疾病与慢性鼻-鼻窦炎(CRS)之间的直接关系具有挑战性。

目的:本研究旨在综述现有文献,并评估反流疾病与 CRS 之间关联的证据。

方法:通过对多个数据库进行全面的电子检索,以确定自 1950 年 1 月 1 日至 2022 年 6 月 16 日期间所有研究 LPR、GERD 和 CRS 之间关系的研究。仅纳入了涉及成年人群的英文手稿的研究,而排除了病例系列、病例报告和体外研究。使用纽卡斯尔-渥太华量表对病例对照研究和 NIH 质量评估工具对观察性队列和横断面研究进行偏倚风险评估。

结果:检索策略共产生了 427 篇文章,其中 25 项研究探讨了反流疾病与 CRS 之间的相关性。荟萃分析表明,与对照组相比,GERD 的存在与 CRS 之间存在显著相关性( < .001;CI 3.56 [2.25, 5.65]),并且 CRS 患者的 pH 值和胃蛋白酶检测值明显高于健康个体( = .003)。此外,所有评估 CRS 患者质子泵抑制剂(PPI)治疗的研究都报告了积极的结果,93%的 CRS 患者在 PPI 治疗后症状改善。

结论:现有文献提供了提示性证据,表明反流疾病与 CRS 之间存在关联,包括患病率和治疗方面。然而,需要进一步的研究来证实这种关系。

相似文献

[1]
Association Between Chronic Rhinosinusitis and Reflux Diseases in Adults: A Systematic Review and Meta-Analysis.

Am J Rhinol Allergy. 2024-1

[2]
Relation between chronic rhinosinusitis and gastroesophageal reflux in adults: systematic review.

Braz J Otorhinolaryngol. 2017

[3]
Association between laryngopharyngeal reflux, gastroesophageal reflux and recalcitrant chronic rhinosinusitis: A systematic review.

Clin Otolaryngol. 2023-7

[4]
Eight weeks of omeprazole 20 mg significantly reduces both laryngopharyngeal reflux and comorbid chronic rhinosinusitis signs and symptoms: Randomised, double-blind, placebo-controlled trial.

Clin Otolaryngol. 2018-4

[5]
The Impact of Laryngopharyngeal Reflux on Patient-reported Measures of Chronic Rhinosinusitis.

Ann Otol Rhinol Laryngol. 2020-9

[6]
How many cases of laryngopharyngeal reflux suspected by laryngoscopy are gastroesophageal reflux disease-related?

World J Gastroenterol. 2012-8-28

[7]
Endoscopic Features of Chronic Rhinosinusitis in Patients with Gastroesophageal Reflux Disease.

Medicina (Kaunas). 2024-8-2

[8]
Effects of pepsin A on heat shock protein 70 response in laryngopharyngeal reflux patients with chronic rhinosinusitis.

Acta Otolaryngol. 2017-12

[9]
[A preliminary study on the relationship between laryngopharyngeal reflux and chronic rhinosinusitis].

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017-12-5

[10]
Prevalence of Gastro-esophageal Reflux Disease in Suspected Laryngo- pharingeal Reflux Unresponsive to Proton-pump Inhibitors.

Rev Recent Clin Trials. 2021

引用本文的文献

[1]
Validity and Reliability of the Singer Reflux Symptom Score (sRSS).

J Pers Med. 2025-8-2

[2]
The Diagnostic Accuracy of the Nasopharyngeal Reflux Endoscopic Score (NRES) for Identifying Laryngopharyngeal Reflux Disease in Chronic Rhinosinusitis.

J Clin Med. 2025-6-17

[3]
Association between Helicobacter pylori, reflux and chronic rhinosinusitis: a systematic review.

Eur Arch Otorhinolaryngol. 2025-2-2

[4]
The Diagnosis and Treatment of Chronic Rhinosinusitis.

Dtsch Arztebl Int. 2024-9-20

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