哮喘联盟

   摘要
   背景: 有研究表明，上呼道疾病与下呼道疾病的发生之间存在相关性，但是，目前还没有研究全面评估鼻窦炎对哮喘患者长期临床转归的影响。
   目的：本项目旨在研究鼻窦炎对哮喘患者疾病进展的影响。
   方法：本研究纳入了75例通过乙酰胆碱支气管激发试验或支气管扩张剂治疗有效性试验等方法诊断的哮喘患者。所有的患者除了哮喘严重程度的评估外还进行了鼻旁窦的X射线检查，并且其在医院的就诊时间大于或等于3年。我们根据并发鼻窦炎的情况对这些患者的医疗记录进行了回顾性比较分析。
   结果：在这75例哮喘患者中 ，38例（50.7%）合并有鼻窦炎（经X射线诊断）。在诊断疾病时，合并有鼻窦炎的哮喘患者其第1秒用力呼气量的值以及PC20的检测值显著低于不合并鼻窦炎的哮喘患者（(FEV1：79.2% vs. 88.2%；PC20: 5.2 mg/mL vs. 8.9 mg/mL）。在随后的三年随访中，两组间的第1秒用力呼气量值的差异并不显著（82.6% vs. 87.2%），但合并鼻窦炎的哮喘患者其第1秒用力呼气量的值比不合并鼻窦炎的哮喘患者变异范围更大（31.7% vs. 23.5%），且最差第1秒用力呼气量的值比不合并鼻窦炎的哮喘患者更低（70.9% vs. 79.0%）。两组患者间的就诊率、急性发作次数以及哮喘控制评分也没有显著差异。
   结论：虽然鼻窦炎被证实与肺功能下降及气道高反应性相关，鼻窦炎的发生与哮喘患者3年随访期间肺功能的恶化程度并不存在显著的相关性。但是，合并鼻窦炎的哮喘患者其3年随访期间肺功能的变异程度更大。两组患者除了抗生素的使用情况不同，其它治疗措施并不存在差异。
 

                                         （苏楠 审校）
Asia Pac Allergy. 2014 Oct;4(4):222-9. doi: 10.5415/apallergy.2014.4.4.222. Epub 2014 Oct 29.

 

The impact of sinusitis on the long-term clinical outcomes of asthma.
 

Kim MH1, Jung JW2, Cho SH3, Min KU3, Kang HR3.
 

ABSTRACT
BACKGROUND: Upper respiratory diseases have been linked with lower respiratory diseases. However, the long-term effect of sinusitis on the clinical outcomes of asthma has not been fully evaluated.
OBJECTIVE: The aim of this study was to investigate the impact of sinusitis on the disease progression of asthma.
METHODS: Seventy-five asthmatic patients confirmed with the methacholine bronchial provocation test or bronchodilator response were included. The study patients underwent paranasal sinus x-ray upon their asthma evaluation and they visited the hospital at least 3 years or longer. We retrospectively reviewed their medical records and compared data according to the presence of comorbid sinusitis.
RESULTS: Among the 75 asthmatic subjects, 38 subjects (50.7%) had radiologic evidence of sinusitis. Asthmatics with sinusitis had significantly lower forced expiratory volume in 1 second (FEV1; 79.2% vs. 88.2%) and PC20 values (5.2 mg/mL vs. 8.9 mg/mL) compared to asthmatics without sinusitis at the time of diagnosis. This difference in FEV1 disappeared (82.6% vs. 87.2%) in the 3-year follow-up, although FEV1 was more variable (31.7% vs. 23.5%) and worst FEV1 was also significantly lower in patients with sinusitis compared to those without (70.9% vs. 79.0%). There were no significant differences in the number of hospital visits, acute exacerbations, and scores for the asthma control test.
CONCLUSION: Although sinusitis was associated with lower baseline lung function and higher hyperreactivity, sinusitis was not related with significant deterioration in lung function over 3 years of follow-up. Asthmatics with sinusitis showed more variability in lung function during the follow-up period. Healthcare utilization was not different except antibiotics use.
 

Asia Pac Allergy. 2014 Oct;4(4):222-9. doi: 10.5415/apallergy.2014.4.4.222. Epub 2014 Oct 29.