Folker R J, Marple B F, Mabry R L, Mabry C S
Department of Otorhinolaryngology, University of Texas Southwestern Medical Center, Dallas 75235-9035, USA.
Laryngoscope. 1998 Nov;108(11 Pt 1):1623-7. doi: 10.1097/00005537-199811000-00007.
To determine the effect of immunotherapy (IT) with fungal antigens on clinical outcome in patients with allergic fungal sinusitis (AFS).
Prospective case control.
In this comparison study, 22 patients meeting the diagnostic criteria of allergic fungal sinusitis (AFS) were evaluated after a mean of 33 months' therapy. All received similar treatment consisting of endoscopic sinus surgery, corticosteroids, and antibiotics as needed for complicating purulent sinusitis. Eleven patients received postoperative immunotherapy (IT) with fungal and nonfungal antigens to which sensitivity had been demonstrated, while the remaining 11 received no immunotherapy.
The effect of IT was to significantly improve patient outcome as assessed objectively by an AFS endoscopic mucosal staging system (P < .001) and a sinusitis-specific quality-of-life scale, the Chronic Sinusitis Survey (P = .002). In addition, IT was shown to reduce reliance on systemic (P < .001) and topical nasal (P = .043) corticosteroid therapy to control disease. Follow-up was similar in the two groups and was not a determinant of differences in outcome (P = .7).
Results from this study indicate that specific IT with fungal antigens improves patient outcome in AFS.
确定真菌抗原免疫疗法（IT）对变应性真菌性鼻窦炎（AFS）患者临床结局的影响。
前瞻性病例对照研究。
在这项比较研究中，对22例符合变应性真菌性鼻窦炎（AFS）诊断标准的患者进行了平均33个月的治疗后评估。所有患者均接受了类似的治疗，包括内窥镜鼻窦手术、皮质类固醇以及根据化脓性鼻窦炎并发症情况使用的抗生素。11例患者术后接受了对其已证明有敏感性的真菌和非真菌抗原免疫疗法（IT），而其余11例未接受免疫疗法。
通过AFS内窥镜黏膜分期系统（P <.001）和鼻窦炎特异性生活质量量表《慢性鼻窦炎调查问卷》（P =.002）客观评估，IT的效果是显著改善患者结局。此外，IT还显示可减少控制疾病对全身（P <.001）和局部鼻用（P =.043）皮质类固醇疗法的依赖。两组的随访情况相似，且不是结局差异的决定因素（P =.7）。
本研究结果表明，真菌抗原特异性IT可改善AFS患者的结局。
