The clinical relationship of nasal polyps to asthma
The clinical relationship of nasal polyps to asthma
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DOI：
10.2500/108854196778662255
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发表时间：
1996-09-01
影响因子：
2.8
通讯作者：
Larsen, K
中科院分区：
文献类型：
--
作者：
Larsen, K
通过对哮喘与鼻息肉临床相关文献的荟萃分析发现，哮喘患者息肉发生率为7% ~ 15%，其中50岁以上年龄组发生率最高。36%至96%的乙酰水杨酸（ASA）不耐受患者发生息肉。鼻息肉患者在耳鼻喉科的平均哮喘发生率为29.9%，在过敏科的平均哮喘发生率超过70%。平均12.8%的患者存在ASA不耐受。男女比例在该系列中呈低值趋势，哮喘和ASA不耐受的发生率最高。并不是所有的息肉患者都有相关的下气道疾病，既没有明显的哮喘，也没有过度反应的气道。患有息肉的女性比男性更容易患哮喘。与没有这些特征的患者相比，有息肉、哮喘和ASA不耐受的患者哮喘和息肉的发病均较晚。平均69%的患者在患息肉前出现哮喘。大多数患者在手术后表现出改善或至少在控制哮喘方面没有变化。鼻内手术中支气管痉挛的发生率不到2%。治疗前和局部麻醉下手术的活动性哮喘被认为是重要的因素。哮喘患者对息肉和鼻窦疾病的控制效果较差，这在ASA不耐受患者中更为明显。本研究支持嗜酸性鼻息肉患者包括具有不同病因因素和不同上、下气道临床结局的患者。鉴别这些实体仍然需要通过基础和临床研究来改善治疗。
From a meta-analysis on the clinical related literature on asthma and nasal polyps, it was found that patients with asthma had polyps in 7 to 15% with the highest frequency in the age group above 50 years. Between 36% and 96% of acetylsalicylic acid (ASA) intolerant patients had polyps. Patients with nasal polyps had asthma at an average of 29.9% in those referred to ENT departments, and more than 70% in those referred to allergy departments. An average of 12.8% had ASA intolerance. Male to female ratio showed a tendency toward lower values in the series, with the highest frequency of asthma and ASA intolerance. Not all polyp patients had an associated lower airway disease, neither as manifest asthma, nor as hypereactive airways on challenge test. Females with polyps were more likely to have asthma than males. Patients with polyps, asthma, and ASA intolerance showed a later onset of both asthma and polyps compared to those without these characteristics. Asthma developed before polyps in an average of 69% of the series. Most patients showed improvement or at the least were unchanged in the control of their asthma after surgery. Bronchospasm during endonasal surgery was observed in less than 2%. Active asthma before treatment and surgery under local anaesthesia have been factors considered important. Control of polyps and sinus disease showed a poorer outcome in patients with asthma, and this was even more pronounced in patients having ASA intolerance. This survey supports the belief that the eosinophilic nasal polyp patients includes patients with different aetiopathogenetic factors and with different clinical outcomes regarding both the upper and lower airways. Identification of such entities is still needed through basic and clinical research to improve treatment.