变应性鼻炎患者三级中心队列中慢性鼻窦炎的累积发病率及其与变应性多病共存的关联：一项长期分析
Cumulative incidence of chronic rhinosinusitis and association with allergic multimorbidity in a tertiary center cohort of patients with allergic rhinitis: a long-term analysis.
文献信息
| PMID | 42931833 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Margherita Ippolito |
| 作者单位 | Unit of Rheumatology, Ospedale S. Chiara, Asuit, Trento, Italy. |
| 期刊 | European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery |
| SCI 分区 | Q1 |
| IF | 2.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景： 变应性鼻炎（AR）影响全球高达50%的成人。本研究旨在评估AR患者中慢性鼻窦炎（CRS）的累积发病率，并探讨CRS与AR临床特征、致敏模式、伴随特应性共病及AR严重程度之间的关联。
方法： 这项回顾性、观察性、多中心研究纳入了首次评估时诊断为AR且无CRS的连续成人患者。收集了从AR发病至末次随访的临床信息数据。
结果： 纳入的198例患者中（女性54.0%，AR诊断时中位年龄19岁，IQR 11-30），随访期间65.2%的患者发生CRS。在发生CRS的患者中，51.2%有影像学确认，31.0%被诊断为伴鼻息肉的CRS（CRSwNP）。多因素分析显示，在AR诊断时无独立预测因素可预测CRS（风险比（HR）及[95%置信区间（CI）]：1.24 [0.68-2.25]，AR诊断时年龄（每岁变化）1.00 [0.98-1.02]，特应性共病1.81 [0.8-4.11]，多致敏0.76 [0.8-1.58]）。末次随访时（距AR诊断中位19 [IQR 9-29]年），47.4%的患者AR为中度持续型。与CRSsNP相比，CRSwNP患者中哮喘（77.5% vs 43.8%，p=0.0005）和ASA超敏反应（27.5% vs 5.6%，p=0.0010）的比例更高。总体而言，末次随访时仅CRS与中度持续型AR独立相关（HR 2.90 [1.51, 5.56]）。
结论： 近三分之二的AR受试者在疾病过程中发生CRS。AR诊断多年后，CRS是唯一与中度持续型AR独立相关的因素，使其风险增加近三倍。
英文摘要
BACKGROUND: Allergic rhinitis (AR) affects up to 50% of adults globally. This study was undertaken to evaluate cumulative incidence of chronic rhinosinusitis (CRS) in patients with AR and to investigate the association between CRS and clinical features of AR, sensitization patterns, concomitant atopic comorbidities and AR severity.
METHOD: This retrospective, observational, multicenter study included consecutive adult patients with a diagnosis of AR without CRS at first assessment. Data covering clinical information from AR onset to the last follow-up were collected.
RESULTS: Out of the 198 patients included (54.0% female, median age at AR diagnosis 19 years old, IQR 11-30), CRS developed in 65.2% of patients during follow-up. Among those who developed CRS, 51.2% had radiological confirmation, and 31.0% were diagnosed with CRS with nasal polyposis (CRSwNP). Multivariate analysis revealed no independent predictors of CRS at the time of AR diagnosis (Hazard ratio (HR) with [95% confidence intervals (CI)] 1.24 [0.68-2.25], age at AR diagnosis (per year change) 1.00 [0.98-1.02], atopic morbidities 1.81 [0.8-4.11], and polysensitization 0.76 [0.8-1.58]). At last follow up (median 19 [IQR 9-29] years from AR diagnosis), AR was moderate-persistent in 47.4%. Patients with CRSwNP have a higher proportion of asthma (77.5% vs 43.8%, p=0.0005) and ASA hypersensitivity (27.5% vs. 5,6%, p=0.0010) as compared to CRSsNP. Overall, only CRS was independently associated to moderate-persistent AR at last follow-up (HR 2.90 [1.51, 5.56]).
CONCLUSION: Almost two-thirds of subjects with AR develop CRS during the disease course. Years after AR diagnosis, CRS is the only independent factor associated with moderate-persistent AR, increasing almost three times its risk.