Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill.
Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md; Department of Population Health Sciences, Geisinger, Danville, Pa.
J Allergy Clin Immunol Pract. 2024 Nov;12(11):3116-3122.e2. doi: 10.1016/j.jaip.2024.07.027. Epub 2024 Aug 5.
Studies have shown an association between chronic rhinosinusitis (CRS) and non-cystic fibrosis (CF) bronchiectasis.
We aimed to determine whether CRS increases the risk of developing non-CF bronchiectasis.
A retrospective analysis was conducted utilizing electronic medical records from an academic center. Patients with CRS without bronchiectasis, with at least 1 chest computed tomography (CT) scan performed after the diagnosis of CRS, were identified between January 2006 and December 2015. Charts were reviewed until May 2022. The control group was age-, sex-, and race-matched, and included patients without CRS, asthma, or chronic obstructive pulmonary disease (COPD) who had at least 1 chest CT scan. Bronchiectasis was identified by chest CT radiology reports. The odds of developing bronchiectasis were analyzed in patients with CRS without asthma or COPD (cohort 1) and patients with CRS with asthma or COPD (cohort 2).
The odds of developing bronchiectasis were significantly higher in patients with CRS (139 of 1,594; 8.7%) than in patients in the control group (443 of 7,992; 5.5%; odds ratio OR 1.63; 95% confidence interval [95% CI] 1.34-1.99). Furthermore, the odds of developing bronchiectasis were higher in cohort 1 (63 of 863; 7.3%; OR 1.34; 05% CI 1.02-1.76) and cohort 2 (76/ of 731; 10.4%; OR 1.98; 95% CI 1.53-2.55) versus the control group. After adjusting for confounding diseases, the association was attenuated in cohort 1 (OR 1.22; 95% CI 0.92-1.61) but remained significant in cohort 2 (OR 1.78; 95% CI 1.37-2.31).
The CRS is associated with the future development of non-CF bronchiectasis. Patients with CRS, especially those with asthma or COPD, have a higher likelihood of developing bronchiectasis than patients without CRS.
研究表明慢性鼻-鼻窦炎（CRS）与非囊性纤维化（CF）支气管扩张之间存在关联。
我们旨在确定 CRS 是否会增加患非 CF 支气管扩张的风险。
利用学术中心的电子病历进行回顾性分析。在 2006 年 1 月至 2015 年 12 月期间，确定了至少在诊断为 CRS 后进行了 1 次胸部计算机断层扫描（CT）检查且无支气管扩张的 CRS 患者。对图表进行了审查，直至 2022 年 5 月。对照组为年龄、性别和种族匹配的患者，包括无 CRS、哮喘或慢性阻塞性肺疾病（COPD）且至少进行了 1 次胸部 CT 扫描的患者。通过胸部 CT 放射学报告确定支气管扩张。在无哮喘或 COPD 的 CRS 患者（队列 1）和有哮喘或 COPD 的 CRS 患者（队列 2）中分析了发生支气管扩张的可能性。
CRS 患者发生支气管扩张的可能性明显高于对照组（139/1594；8.7%）（443/7992；5.5%）（优势比[OR]1.63；95%置信区间[95%CI]1.34-1.99）。此外，队列 1（863 例中的 63 例；7.3%）（OR 1.34；05%CI 1.02-1.76）和队列 2（731 例中的 76 例；10.4%）（OR 1.98；95%CI 1.53-2.55）发生支气管扩张的可能性均高于对照组。在校正混杂疾病后，队列 1 的关联减弱（OR 1.22；95%CI 0.92-1.61），但队列 2仍有显著关联（OR 1.78；95%CI 1.37-2.31）。
CRS 与非 CF 支气管扩张的未来发展有关。CRS 患者，尤其是有哮喘或 COPD 的患者，发生支气管扩张的可能性高于无 CRS 的患者。
