伴有鼻息肉的慢性鼻窦炎中2型和非2型内型的生活质量：一项前瞻性试验。
Quality of life in type 2 and non-type 2 endotypes in chronic rhinosinusitis with nasal polyps: A prospective trial.
作者信息
Bogaert Stijn, Rheindorf Elisabeth, Dazert Stefan, Volkenstein Stefan, Knipps Lisa, Park Jonas Jae-Hyun, Pfaar Oliver
机构信息
Department of Otorhinolaryngology, Head and Neck Surgery, St. Elisabeth-Hospital, Ruhr University Bochum, Bochum, Germany.
Department of Otorhinolaryngology, Head and Neck Surgery, Johannes Wesling Medical Center Minden, Ruhr University Bochum, Minden, Germany.
出版信息
Clin Transl Allergy. 2025 Jun;15(6):e70070. doi: 10.1002/clt2.70070.
BACKGROUND
In current clinical practice, primary diffuse chronic rhinosinusitis with nasal polyps (CRSwNP) is classified into two endotypes: type 2 and non-type 2. Previous studies on sinonasal health-related quality of life (HRQoL) in CRS have primarily focused on differences between phenotypes. This study aimed to compare HRQoL between the two endotypes in patients with CRSwNP. The type 2 endotype had a higher median nasal polyp score (NPS) than non-types (4 and 2, respectively), but this difference did not reach significance. Loss of smell was associated with NPS, and facial pain/pressure was inversely correlated with age. Age was significantly associated with loss of smell, but only in non-type 2 CRSwNP.
METHODS
This was a prospective, monocentric study conducted between 2018 and 2023 on CRSwNP patients referred for surgery. Health-related quality of life was assessed using the German standardized SNOT-20 questionnaire. Type 2 was defined according to the updated EPOS/EUFOREA 2023 criteria.
RESULTS
A total of 122 patients with CRSwNP were included, 113 (92.6%) of whom were classified as type 2. Type 2 was associated with a significantly worse SNOT-20 German Adapted Version score. Two of the four cardinal symptoms of CRS-loss of smell and rhinorrhea-were significantly more severe and prevalent in the type 2 endotype, with loss of smell being very specific. The most prevalent symptom in both endotypes was nasal obstruction, with no difference between both endotypes. The type 2 endotype had a higher median nasal polyp score (NPS) than non-types (4 and 2, respectively), but this difference did not reach significance. Loss of smell was associated with NPS, and facial pain/pressure was inversely correlated with age. Age was significantly associated with loss of smell, but only in non-type 2 CRSwNP.
CONCLUSION
Type 2 CRSwNP has a more severe impact on HRQoL compared with non-type 2 CRSwNP. Hyposmia, rhinorrhea, and potentially NPS may offer endotypic and pathophysiological insights.
背景
在当前临床实践中，原发性弥漫性慢性鼻窦炎伴鼻息肉（CRSwNP）分为两种内型：2型和非2型。先前关于慢性鼻窦炎（CRS）中鼻窦健康相关生活质量（HRQoL）的研究主要集中在不同表型之间的差异。本研究旨在比较CRSwNP患者两种内型之间的HRQoL。2型内型的鼻息肉评分中位数（NPS）高于非2型（分别为4和2），但这种差异未达到显著水平。嗅觉丧失与NPS相关，面部疼痛/压迫感与年龄呈负相关。年龄与嗅觉丧失显著相关，但仅在非2型CRSwNP中如此。
方法
这是一项于2018年至2023年对因手术转诊的CRSwNP患者进行的前瞻性单中心研究。使用德国标准化的SNOT - 20问卷评估健康相关生活质量。2型根据更新后的2023年EPOS/EUFOREA标准定义。
结果
共纳入122例CRSwNP患者，其中113例（92.6%）被分类为2型。2型与显著更差的SNOT - 20德改编版评分相关。CRS的四个主要症状中的两个——嗅觉丧失和流涕——在2型内型中明显更严重且更普遍，其中嗅觉丧失非常具有特异性。两种内型中最常见的症状都是鼻塞，两种内型之间没有差异。2型内型的鼻息肉评分中位数（NPS）高于非2型（分别为4和2），但这种差异未达到显著水平。嗅觉丧失与NPS相关，面部疼痛/压迫感与年龄呈负相关。年龄与嗅觉丧失显著相关，但仅在非2型CRSwNP中如此。
结论
与非2型CRSwNP相比，2型CRSwNP对HRQoL的影响更严重。嗅觉减退、流涕以及潜在的NPS可能提供内型和病理生理学方面的见解。
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