与年龄相关的鼻炎-鼻窦炎及鼻息肉与哮喘发作的关系
2018/06/04
摘要
背景：慢性鼻炎 - 鼻窦炎（CRS）是一种高发病率的主要疾病，并可能影响成人下呼吸道疾病的状态。然而，它与成人哮喘发作和活动的关系尚未在一般成年人群中详细探究。
目的：探讨CRS与鼻息肉和哮喘特征的关系。
方法：我们分析了2010 - 2012年韩国全国健康和营养调查机构的数据库中17,506名成年人（年龄≥18岁）的横断面数据集。根据国际指南使用结构式问卷确定CRS，并使用鼻内窥镜客观评估鼻息肉的存在。使用结构化问卷来调查哮喘的存在及其发病和目前的活动。
结果：CRS与哮喘显着相关，具体要从CRS以及哮喘的状态来分析。 伴有鼻息肉的CRS（CRSwNP）与成人发病的哮喘（18岁后发病）或迟发性哮喘（40岁后发病）显著相关，而没有鼻息肉的CRS（CRSsNP）与儿童发作性哮喘（18岁之前发病）或成人早发型哮喘（40岁以前发病）相关。两个CRS亚组均显示与当前哮喘显著相关，但与过去的哮喘无关。然而，CRS患者并发哮喘的发生率低于10％。
结论：这项研究发现了CRSwNP和哮喘的明显年龄相关模式，并在一般人群中证明了它们之间的重要联系。然而，CRSwNP哮喘的低流行率与西方人群的发现形成鲜明对比，这需要进一步调查CRSwNP-哮喘关系的种族或地区差异。
Age-related prevalence of chronic rhinosinusitis and nasal polyps and theirrelationships with asthma onset
Ha-Kyeong Won, et al
Abstract
BACKGROUND：Chronic rhinosinusitis (CRS) is a major disease condition with high morbidity, and may influence lower airway disease status in adults. However, its associations with adult asthma onset and activity have not been examined in detail in a general adult population.
OBJECTIVE：To investigate the relationships between CRS with nasal polyps and asthma characteristics.
METHODS：A cross-sectional dataset from 17,506 adult participants (age≥18 years) in the Korean National Health and Nutrition Examination Survey 2010-2012 was analyzed. CRS was defined using structured questionnaires according to the international guideline, and presence of nasal polyps was objectively assessed using nasal endoscope. Presence of asthma and its onset and current activity were asked using structured questionnaires.
RESULTS：CRS was significantly related with asthma, but the relationships were distinct by CRS and asthma status. CRS with nasal polyps (CRSwNP) was significantly associated with adult-onset asthma (onset after 18 years) or late-onset asthma (onset after 40 years), whereas CRS without nasal polyps (CRSsNP) were related to childhood-onset asthma (onset before 18 years) or early-onset asthma (onset before 40 years) in adults. Both CRS subgroups showed significant associations with current asthma but not with past
asthma. However, comorbid asthma rate was less than 10% among subjects with CRS.
CONCLUSIONS:This study found distinct age-related patterns of CRSwNP and asthma and demonstrated their significant associations in a general population. However, low prevalence of asthma in CRSwNP is in sharp contrast to the findings in Western populations, which warrants further investigation for ethnic or regional difference in CRSwNP-asthma relationships.
背景：慢性鼻炎 - 鼻窦炎（CRS）是一种高发病率的主要疾病，并可能影响成人下呼吸道疾病的状态。然而，它与成人哮喘发作和活动的关系尚未在一般成年人群中详细探究。
目的：探讨CRS与鼻息肉和哮喘特征的关系。
方法：我们分析了2010 - 2012年韩国全国健康和营养调查机构的数据库中17,506名成年人（年龄≥18岁）的横断面数据集。根据国际指南使用结构式问卷确定CRS，并使用鼻内窥镜客观评估鼻息肉的存在。使用结构化问卷来调查哮喘的存在及其发病和目前的活动。
结果：CRS与哮喘显着相关，具体要从CRS以及哮喘的状态来分析。 伴有鼻息肉的CRS（CRSwNP）与成人发病的哮喘（18岁后发病）或迟发性哮喘（40岁后发病）显著相关，而没有鼻息肉的CRS（CRSsNP）与儿童发作性哮喘（18岁之前发病）或成人早发型哮喘（40岁以前发病）相关。两个CRS亚组均显示与当前哮喘显著相关，但与过去的哮喘无关。然而，CRS患者并发哮喘的发生率低于10％。
结论：这项研究发现了CRSwNP和哮喘的明显年龄相关模式，并在一般人群中证明了它们之间的重要联系。然而，CRSwNP哮喘的低流行率与西方人群的发现形成鲜明对比，这需要进一步调查CRSwNP-哮喘关系的种族或地区差异。
（复旦大学附属中山医院 呼吸内科 罗锦龙 摘译 杨冬 审校）
（Ann Allergy Asthma Immunol, 2018 Feb 9.）
（Ann Allergy Asthma Immunol, 2018 Feb 9.）
Age-related prevalence of chronic rhinosinusitis and nasal polyps and theirrelationships with asthma onset
Ha-Kyeong Won, et al
Abstract
BACKGROUND：Chronic rhinosinusitis (CRS) is a major disease condition with high morbidity, and may influence lower airway disease status in adults. However, its associations with adult asthma onset and activity have not been examined in detail in a general adult population.
OBJECTIVE：To investigate the relationships between CRS with nasal polyps and asthma characteristics.
METHODS：A cross-sectional dataset from 17,506 adult participants (age≥18 years) in the Korean National Health and Nutrition Examination Survey 2010-2012 was analyzed. CRS was defined using structured questionnaires according to the international guideline, and presence of nasal polyps was objectively assessed using nasal endoscope. Presence of asthma and its onset and current activity were asked using structured questionnaires.
RESULTS：CRS was significantly related with asthma, but the relationships were distinct by CRS and asthma status. CRS with nasal polyps (CRSwNP) was significantly associated with adult-onset asthma (onset after 18 years) or late-onset asthma (onset after 40 years), whereas CRS without nasal polyps (CRSsNP) were related to childhood-onset asthma (onset before 18 years) or early-onset asthma (onset before 40 years) in adults. Both CRS subgroups showed significant associations with current asthma but not with past
asthma. However, comorbid asthma rate was less than 10% among subjects with CRS.
CONCLUSIONS:This study found distinct age-related patterns of CRSwNP and asthma and demonstrated their significant associations in a general population. However, low prevalence of asthma in CRSwNP is in sharp contrast to the findings in Western populations, which warrants further investigation for ethnic or regional difference in CRSwNP-asthma relationships.
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