在接受鼻窦手术的慢性鼻窦炎伴鼻息肉患者中识别重度嗜酸性粒细胞性哮喘
Identification of severe eosinophilic asthma in patients with chronic rhinosinusitis and nasal polyps who are awaiting sinus surgery.
文献信息
| PMID | 42733480 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Drew Davies |
| 作者单位 | Department of Respiratory Medicine and, Musgrove Park Hospital, Somerset NHS Foundation Trust, Taunton, Somerset, United Kingdom. |
| 期刊 | The journal of allergy and clinical immunology. Global |
| SCI 分区 | Q3 |
| IF | 2.7 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景： 慢性鼻窦炎伴鼻息肉（CRSwNP）是重度哮喘人群中常见的合并症；其存在与疾病严重程度增加和嗜酸性粒细胞性炎症相关，可能需要生物制剂治疗。
目的： 我们试图在因鼻息肉等待功能性内镜鼻窦手术（FESS）的CRSwNP患者群体中识别可能的重度嗜酸性粒细胞性哮喘患者。
方法： 我们在地区综合医院对等待FESS的CRSwNP患者进行了服务评估。我们筛查了电子记录中的嗜酸性粒细胞水平、既往哮喘诊断、症状和药物治疗。
结果： 在耳鼻喉科等待名单上的709名患者中，有123名CRSwNP患者等待FESS。在这些患者中，74名有既往嗜酸性粒细胞增多（血清嗜酸性粒细胞计数≥0.3 x10^9/L），32%为女性，平均年龄为53.5岁（标准差15岁）。在这74名患者中，36名有预先存在的哮喘诊断，其中61%处于全球哮喘防治创议指南的第4或第5步，18%在过去12个月内接受了2个或更多疗程的口服类固醇，41%不为当地哮喘服务机构所知，27%正在接受哮喘生物制剂治疗。此外，在因鼻息肉等待FESS且无既往哮喘诊断的嗜酸性粒细胞增多患者中（74名中的38名），26%有记录的气短或喘息症状。
结论： 我们识别了等待鼻息肉手术的CRSwNP患者，他们患有嗜酸性粒细胞性哮喘，可能受益于治疗优化和重度哮喘服务的审查。主动识别当前等待FESS的重度哮喘合并CRSwNP患者可能会扩大获得哮喘优化和生物药物的机会。
英文摘要
BACKGROUND: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a common comorbidity within severe asthma populations; its presence is associated with increased severity of disease and eosinophilic inflammation that may require biologic therapies.
OBJECTIVE: We sought to identify potential patients with severe eosinophilic asthma in a population of patients with CRSwNP who were awaiting functional endoscopic sinus surgery (FESS) for nasal polyps.
METHODS: We conducted a service evaluation of patients with CRSwNP who were awaiting FESS in a district general hospital. We screened electronic records for eosinophil levels, previous asthma diagnosis, symptoms, and medical treatment.
RESULTS: Of the 709 patients on the otolaryngology waiting list, 123 patients with CRSwNP were awaiting FESS. Of those patients, 74 had previous eosinophilia (serum eosinophil count ≥ 0.3 x109/L), 32% were female, and their mean age was 53.5 years (SD 15 years). Of those 74 patients, 36 had a preexisting diagnosis of asthma, of whom 61% were at step 4 or 5 of the Global Initiative for Asthma guidelines, with 18% receiving 2 or more courses of oral steroids in the previous 12 months, 41% unknown to local asthma services, and 27% receiving biologic therapy for asthma. In addition, of those with eosinophilia with no previous asthma diagnosis who were awaiting FESS for nasal polyps (38 of 74), 26% had documented symptoms of breathlessness or wheeze.
CONCLUSION: We have identified patients with CRSwNP awaiting nasal polyp surgery who have eosinophillic asthma that may benefit from treatment optimization and review in a severe asthma service. Proactive identification of patients with severe asthma and comorbid CRSwNP who are currently awaiting FESS may widen access to asthma optimization and biologic medications.