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内镜鼻窦手术治疗伴有嗜酸性慢性鼻-鼻窦炎的严重哮喘患者的气流受限和气道炎症。

Relief of Airflow Limitation and Airway Inflammation by Endoscopic Sinus Surgery in a Patient with Severe Asthma with Eosinophilic Chronic Rhinosinusitis.

机构信息

Yamaguchi-Ube Medical Center, Japan.

Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Japan.

出版信息

Intern Med. 2024 Aug 15;63(16):2317-2320. doi: 10.2169/internalmedicine.2918-23. Epub 2024 Jan 13.

DOI:10.2169/internalmedicine.2918-23
PMID:38220196
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11414368/
Abstract

Although endoscopic sinus surgery (ESS) is beneficial in improving asthma symptoms, its impact on the lung function in patients with asthma and chronic rhinosinusitis remains unclear. We herein report a case of severe asthma with eosinophilic chronic rhinosinusitis, in which ESS substantially improved airflow limitation and concomitantly reduced fractional exhaled nitric oxide and blood eosinophil counts. ESS likely relieved airflow limitation by suppressing type 2 inflammatory pathways. This case highlights ESS as a promising strategy for achieving clinical remission in patients with severe asthma and chronic rhinosinusitis.

摘要

尽管内镜鼻窦手术（ESS）有益于改善哮喘症状，但它对哮喘和慢性鼻-鼻窦炎患者的肺功能的影响仍不清楚。我们在此报告一例严重哮喘伴嗜酸性慢性鼻-鼻窦炎患者，ESS 显著改善了气流受限，并同时降低了呼出气一氧化氮分数和血嗜酸性粒细胞计数。ESS 可能通过抑制 2 型炎症途径来缓解气流受限。该病例提示 ESS 是实现严重哮喘和慢性鼻-鼻窦炎患者临床缓解的一种有前途的策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c03/11414368/7c18397e217e/1349-7235-63-2317-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c03/11414368/a2828a0073c9/1349-7235-63-2317-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c03/11414368/7c18397e217e/1349-7235-63-2317-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c03/11414368/a2828a0073c9/1349-7235-63-2317-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c03/11414368/7c18397e217e/1349-7235-63-2317-g002.jpg

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本文引用的文献

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A Real-World Study of Achievement Rate and Predictive Factors of Clinical and Deep Remission to Biologics in Patients with Severe Asthma.重度哮喘患者使用生物制剂实现临床和深度缓解的成功率及预测因素的真实世界研究
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Mepolizumab improves sino-nasal symptoms and asthma control in severe eosinophilic asthma patients with chronic rhinosinusitis and nasal polyps: a 12-month real-life study.美泊利珠单抗改善伴有鼻息肉的慢性鼻-鼻窦炎和重度嗜酸性粒细胞性哮喘患者的鼻窦-鼻部症状和哮喘控制：一项为期 12 个月的真实世界研究。
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Cost Utility Analysis of Dupilumab Versus Endoscopic Sinus Surgery for Chronic Rhinosinusitis With Nasal Polyps.度普利尤单抗与内镜鼻窦手术治疗鼻息肉慢性鼻-鼻窦炎的成本效用分析。
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J Asthma. 2021 Jun;58(6):750-758. doi: 10.1080/02770903.2020.1729380. Epub 2020 Feb 19.