Article record

囊性纤维化患者的环境暴露、慢性鼻窦炎与嗅觉

Environmental Exposures, Chronic Sinusitis, and Olfaction in People With Cystic Fibrosis.

临床研究鼻科IF 4.9Q1

文献信息

PMID	42893525
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Benton Tullis 查看其他 31 位作者 Larissa Nicolas；Jeremiah A Alt；Todd E Bodner；Michael Chang；Naweed I Chowdhury；Sei Chung；Patricia Eshaghian；Yuqing A Gao；Anne Getz；Amarbir S Gill；Peter H Hwang；Ashoke Khanwalkar；Adam J Kimple；Todd Kingdom；Jivianne T Lee；Douglas A Li；Jess C Mace；Jayakar V Nayak；Meghan Norris；Jonathan B Overdevest；Zara M Patel；Katie Poch；Rodney J Schlosser；Kristine A Smith；Zachary M Soler；Jeffrey D Suh；Grant A Turner；Marilene B Wang；Milene T Saavedra；Jennifer L Taylor；Daniel M Beswick
作者单位	Department of Otolaryngology - Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA. 查看其他 14 条单位信息 Department of Otolaryngology - Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA.；Department of Psychology, Portland State University, Portland, Oregon, USA.；Department of Otolaryngology - Head and Neck Surgery, Stanford University, Stanford, California, USA.；Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.；Department of Otolaryngology, University of Texas Southwestern, Dallas, Texas, USA.；Department of Pulmonary Medicine, University of California Los Angeles, Los Angeles, California, USA.；Department of Otolaryngology - Head and Neck Surgery, University of Colorado, Aurora, Colorado, USA.；Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA.；Department of Otolaryngology - Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA.；Department of Pediatric Pulmonary Medicine, University of California Los Angeles, Los Angeles, California, USA.；Department of Otolaryngology - Head and Neck Surgery, Oregon Health & Science University, Portland Oregon, USA.；Department of Otolaryngology, Columbia University Medical Center, New York, New York, USA.；Department of Medicine, National Jewish Health, Denver, Colorado, USA.；Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
期刊	International forum of allergy & rhinology
SCI 分区	Q1
IF	4.9
研究类型	临床研究 · 临床
所属专科	鼻科

中文摘要

背景： 环境空气污染物可能参与慢性鼻窦炎（CRS）的发生，但其与囊性纤维化（CF）患者上气道疾病的关系仍知之甚少。本研究评估了成人CF合并CRS患者长期环境空气污染物暴露与CRS严重程度及嗅觉功能障碍之间的关联。
方法： 2019年至2023年期间，从美国多家学术性鼻科中心前瞻性纳入80例CF合并CRS的成人患者。通过将每位参与者居住地邮政编码对应的最近美国环境保护署监测站进行链接，估算其对PM2.5、PM10、CO、SO2、NO2和臭氧的长期暴露，并计算入组前3年平均暴露量。采用Lund-Kennedy内镜评分、Lund-Mackay CT评分、SNOT-22、嗅觉障碍问卷-阴性陈述（QOD-NS）及40项气味识别测试评估CRS严重程度和嗅觉。分析采用Spearman相关和非参数组间比较。
结果： 较高的臭氧暴露与更差的SNOT-22总分相关（Rs = 0.34，p = 0.002），包括耳/面部、心理和睡眠功能障碍领域，也与更差的嗅觉特异性结局相关，包括更高的QOD-NS评分（Rs = 0.30，p = 0.007）和更低的气味识别测试评分（Rs = -0.30，p = 0.018）。其他污染物与CRS或嗅觉结局未见显著关联。
结论： 在CF合并CRS的成人中，较高的长期环境臭氧暴露与更大的鼻窦症状负担和更差的嗅觉功能相关。这些发现提示臭氧可能是该人群上气道疾病严重程度的环境影响因素，并支持在更大规模、经校正分析的研究中进一步探讨。
要点： 臭氧污染增加与CF患者更严重的CRS相关。在CF合并CRS人群中，较高的臭氧暴露与更差的嗅觉功能相关。

英文摘要

BACKGROUND: Environmental air pollutants may contribute to chronic rhinosinusitis (CRS), but their relationship with upper airway disease in people with cystic fibrosis (CF) remains poorly understood. This study evaluated associations between long-term ambient air pollutant exposure and CRS severity and olfactory dysfunction in adults with CF and CRS.
METHODS: 80 adults with CF and comorbid CRS were prospectively enrolled from 2019 to 2023 at multiple U.S. academic rhinology centers. Long-term exposure to PM2.5, PM10, CO, SO2, NO2, and ozone was estimated using the nearest U.S. Environmental Protection Agency monitor linked to each participant's residential ZIP code, with 3-year mean exposure calculated before enrollment. CRS severity and olfaction were assessed using Lund-Kennedy endoscopy scores, Lund-Mackay CT scores, SNOT-22, Questionnaire of Olfactory Disorders-Negative Statements, and 40-item Smell Identification Test. Analyses used Spearman correlations and nonparametric group comparisons.
RESULTS: Higher ozone exposure was associated with worse total SNOT-22 scores (Rs = 0.34 p = 0.002), including ear/facial, psychological, and sleep dysfunction domains, as well as worse olfactory-specific outcomes, including higher QOD-NS scores (Rs = 0.30, p = 0.007) and lower Smell Identification Test scores (Rs = -0.30, p = 0.018). Other pollutants did not show significant associations with CRS or olfactory outcomes.
CONCLUSIONS: In adults with CF and CRS, higher long-term ambient ozone exposure was associated with greater sinonasal symptom burden and worse olfactory function. These findings suggest that ozone may be an environmental contributor to upper airway disease severity in this population and support further study in larger, adjusted analyses.
KEY POINTS: Increased ozone pollution correlates with more severe CRS in people with CF. Among people with CF and CRS, higher ozone exposure is associated with worse olfactory function.