哮喘联盟

   摘要
   超过50%的慢性鼻窦炎（CRS）患者合并哮喘，之前研究报道过部分有鼻息肉的CRS （CRSwNP）患者鼻息肉（NP）中的自身抗原特异性抗体增加。近来发现女性的哮喘和自身免疫疾病的患病率和/或严重程度增加，但是女性CRSwNP的发病率和严重程度是否高于男性并不清楚。研究旨在确定CRSwNP在发病率和严重程度方面是否存在性别差异。研究采用三级医院患者的回顾性数据库(n = 1393)，评估CRSwNP合并或不合并哮喘或阿司匹林过敏患者的性别分布。研究进一步比较了CRSwNP男性患者和女性患者的鼻窦疾病严重程度。虽然女性在不合并NP的CRS (CRSsNP)患者中占55%，但是CRSwNP患者中女性的比例显著较少(38%, P < 0.001)。有趣的是，CRSwNP女性患者较男性患者更易合并哮喘(P < 0.001)，且合并最严重形式的疾病（阿司匹林加重性呼吸道疾病(CRSwNP+哮喘+阿司匹林过敏)）的61% 患者为女性(P < 0.05)。CRSwNP女性患者较男性患者更易口服类固醇药物和有修复手术病史。这些数据表明在三级医院中的CRSwNP患者中，女性较男性更易患严重的疾病。未来的研究应对导致男性和女性疾病严重程度的不同的机制进行探讨，为基于性别的CRSwNP个性化治疗的发展提供新的思路。
 

（杨冬 审校）
Immun Inflamm Dis. 2015 Mar;3(1):14-22. doi: 10.1002/iid3.46. Epub 2015 Feb 12.
 

A retrospective, cross-sectional study reveals that women with CRSwNP have more severe disease than men.
 

Stevens WW1, Peters AT1, Suh L1, Norton JE1, Kern RC2, Conley DB2, Chandra RK2, Tan BK2, Grammer LC1,Harris KE1, Carter RG1, Kato A1, Urbanek M3, Schleimer RP4, Hulse KE1.

Author information
 

Abstract
Up to 50% of patients with chronic rhinosinusitis (CRS) have comorbid asthma, and we have reported that a subset of CRS patients who have nasal polyps (CRSwNP) have elevated autoantigen-specific antibodies within their nasal polyps (NP). While increases in the prevalence and/or severity of both asthma and autoimmunity in women are well characterized, it is not known whether CRSwNP is more severe or frequent in women than men. We sought to determine whether CRSwNP demonstrated sex-specific differences in frequency and/or severity. Using a retrospectively collected database of tertiary care patients (n = 1393), we evaluated the distribution of sex in patients with CRSwNP with or without comorbid asthma or aspirin hypersensitivity. We further compared the severity of sinus disease between men and women with CRSwNP. Although women comprised 55% of CRS patients without NP (CRSsNP), a significantly smaller proportion of CRSwNP patients were female (38%, P < 0.001). Interestingly, women with CRSwNP were significantly more likely than men to have comorbid asthma (P < 0.001), and 61% of patients with the most severe form of disease (aspirin-exacerbated respiratory disease (CRSwNP plus asthma plus aspirin sensitivity)) were women (P < 0.05). Women with CRSwNP were significantly more likely to have taken oral steroids, and were more likely to have a history of revision surgeries (P < 0.05) compared to men. These data suggest that women with CRSwNP have more severe disease than men in a tertiary care setting. Future studies are needed to elucidate the mechanisms that drive disease severity in men and women, paving the way for the development of personalized treatment strategies for CRSwNP based on sex.
 

Immun Inflamm Dis. 2015 Mar;3(1):14-22. doi: 10.1002/iid3.46. Epub 2015 Feb 12.