哮喘联盟

   摘要
   背景：伴或不伴过敏性鼻炎(AR)的慢性鼻窦炎(CRS)对哮喘的长期影响尚不清楚。本研究旨在分析持续性鼻窦炎和过敏性鼻炎对哮喘影响的潜在关系。
   方法：研究对象为2010年MarketScan™理赔数据库中慢性鼻窦炎和行内窥镜鼻窦手术(ESS)的患者。所有患者鼻窦炎首次确诊的日期均已明确。鼻窦炎首次确诊时伴有哮喘的患者排除在外。其余患者根据鼻窦炎持续时间，首次确诊至手术的时间，分为4组：1组：1≤年数<2 (n = 181)；2组：2≤年数<3 (n = 195)；3组：3≤年数<4 (n = 292)；4组：4≤年数<5 (n = 536)。评估各组每年新诊断哮喘的发病率和患病率。二次分析则评估过敏性鼻炎与哮喘之间的关系。
   结果：术前，每年新诊断哮喘的发病率平均为4.48%(95% CI: 3.93% - 5.11%)，伴有过敏性鼻炎的患者发病率(5.93%; 95% CI : 4.56% - 7.66%)显著高于不伴有过敏性鼻炎的患者 (4.15%; 95% CI : 3.56% - 4.82%)，p = 0.03。术后，每年哮喘发病率为0.42% (95% CI : 0.18% - 0.88%)。所有患者鼻窦炎首次确诊时均无哮喘；然而，截止至手术时，1-4组分别有9.4%、12.8%、18.2%和22.40%的患者被确诊患有哮喘。
   结论：过敏性鼻炎是慢性鼻窦炎患者哮喘发病的重要危险因素。顽固性慢性鼻窦炎与哮喘的高发病率相关，而鼻窦炎术后哮喘发病率下降。因此，越早行手术治疗的患者，哮喘发病风险越低。

 

(杨冬 审校)
Int Forum Allergy Rhinol. 2015 Dec 1.doi: 10.1002/alr.21652. [Epub ahead of print]

Impact of medically recalcitrant chronic rhinosinusitis on incidence of asthma.
 

Benninger MS1, Sindwani R1, Holy CE2, Hopkins C3.
 

Abstract
BACKGROUND:The long-term impact of chronic rhinosinusitis (CRS) with or without allergic rhinitis (AR) on asthma is poorly documented. This study analyzed potential associations of ongoing CRS and AR on asthma.
METHODS:Using the MarketScan™ claims database, patients with CRS and endoscopic sinus surgery (ESS) in 2010 were identified. The date of first sinusitis was determined for all. Patients with asthma at time of first sinusitis diagnosis were excluded. The remaining patients were grouped based on duration of sinusitis, from first diagnosis to surgery-group 1: 1 to <2 years (n = 181); group 2: 2 to <3 years (n = 195); group 3: 3 to <4 years (n = 292); and group 4: 4 to <5 years (n = 536). Yearly incidence and prevalence of newly diagnosed asthmatics was analyzed for all groups. A secondary analysis evaluated the association between AR and asthma.
RESULTS:Preoperatively, yearly incidence of patients with new asthma diagnoses averaged 4.48% (95% confidence interval [CI], 3.93% to 5.11%) and was significantly greater for patients with AR (5.93%; 95% CI, 4.56% to 7.66%) vs non-AR (4.15%; 95% CI, 3.56% to 4.82%); p = 0.03. Postoperatively, yearly incidence of asthma was 0.42% (95% CI, 0.18% to 0.88%). No patient had asthma at time of first diagnosis; however, by time of surgery, 9.4%, 12.8%, 18.2%, and 22.40% of patients had been diagnosed with asthma, in groups 1 through 4, respectively.
CONCLUSION:AR was a significant risk factor for asthma in patients with CRS. Medically recalcitrant CRS was associated with high incidence rates of asthma, which declined post-operatively. Patients operated earlier in the disease continuum were therefore at decreased risk of developing asthma.
 

Int Forum Allergy Rhinol. 2015 Dec 1.doi: 10.1002/alr.21652. [Epub ahead of print]