Sinus computed tomography predicts clinical response to corticosteroids in chronic rhinosinusitis with nasal polyps.
Sinus computed tomography predicts clinical response to corticosteroids in chronic rhinosinusitis with nasal polyps.
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鼻窦计算机断层扫描预测慢性鼻窦炎伴鼻息肉对皮质类固醇的临床反应
DOI：
10.1186/s13601-018-0211-1
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发表时间：
2018
影响因子：
4.4
通讯作者：
Sun Y
中科院分区：
文献类型：
--
作者：
Hong H;Wang D;Tan KS;Zheng R;Chen F;Gao W;He H;Shi J;Fan Y;Yang Q;Sun Y
慢性鼻窦炎伴鼻息肉（CRSwNP）是一种异质性炎症性疾病，通常以鼻窦粘膜慢性嗜酸性粒细胞增多为特征，通常需要糖皮质激素（GC）治疗。然而，治疗反应在个体之间显著不同。本研究的目的是评估鼻窦计算机断层扫描（CT）对CRSwNP患者GC敏感性的诊断价值。我们对47例连续CRSwNP患者进行了前瞻性单盲研究。口服泼尼松30 mg/d，疗程14 d，根据鼻息肉大小评分的变化分为客观GC敏感和不敏感亚组，根据鼻症状总评分的变化分为主观GC敏感和不敏感亚组。比较了GC敏感和GC不敏感亚组之间的以下参数：Lund-Mackay评分、嗅裂（OC）评分、血嗜酸性粒细胞计数和比率（占总白色血细胞的百分比）。25/47例（53.2%）和29/47例（61.7%）患者客观和主观上分别对GC治疗敏感。GC敏感亚组的OC评分、血嗜酸性粒细胞计数及比值均显著高于GC不敏感亚组。多因素Logistic回归分析显示OC评分是客观或主观GC敏感性的独立危险因素。OC评分显示出与血液嗜酸性粒细胞比率相当的准确性，作为客观和主观GC敏感性的预测因子（OC评分AUC分别为0.775和0.829）。OC评分3.5可作为预测CRSwNP对GC治疗的临床反应的可靠指标。我们的前瞻性研究结果验证了鼻窦CT扫描在预测CRSwNP患者GC敏感性方面的潜在价值。本文的在线版本（10.1186/s13601-018-0211-1）包含补充材料，可供授权用户使用。
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a heterogeneous inflammatory disease usually characterized by chronic eosinophilia in the sinonasal mucosa, which often requires glucocorticoid (GC) therapy. However, the therapeutic response varies markedly between individuals. The objective of this study was to evaluate the diagnostic values of sinus computed tomography (CT) for GC-sensitivity in patients with CRSwNP. We conducted a prospective, single-blinded study of 47 consecutive patients with CRSwNP. These patients were given a course of oral prednisone (30 mg daily for 14 days) and subsequently classified into objectively GC-sensitive and -insensitive subgroup according to the change in nasal polyp size score, or subjectively GC-sensitive and -insensitive subgroup according to the change in total nasal symptom score. The following parameters were compared between GC-sensitive and GC-insensitive subgroups: Lund-Mackay scores, olfactory cleft (OC) scores, and blood eosinophil counts and ratio (percentage of the total white blood cells). 25/47 (53.2%) and 29/47 (61.7%) patients were objectively and subjectively sensitive to GC therapy, respectively. The OC score and the blood eosinophil counts and ratio in GC-sensitive subgroup were significantly higher than those in GC-insensitive subgroup, defined either objectively or subjectively. Multivariate logistic regression revealed that OC score was independent risk factor for objective or subjective GC-sensitivity. The OC score exhibited comparable accuracy with the blood eosinophil ratio as predictor of objective and subjective GC-sensitivity (the OC score AUC = 0.775 and 0.829, respectively). A OC score of 3.5 could act as a reliable indicator for predicting the clinical response to GC therapy in CRSwNP. Our prospective findings validate the potential value of sinus CT scan in predicting GC-sensitivity in CRSwNP patients. The online version of this article (10.1186/s13601-018-0211-1) contains supplementary material, which is available to authorized users.
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慢性鼻窦炎流行病学：中国七个城市的横断面调查结果
影响因子：
12.4
作者：
Shi JB;Fu QL;Zhang H;Cheng L;Wang YJ;Zhu DD;Lv W;Liu SX;Li PZ;Ou CQ;Xu G
通讯作者：
Xu G
影响因子：
1.4
作者：
Racette, Samuel D.;Wijewickrama, Rohan C.;Ponikau, Jens U.
通讯作者：
Ponikau, Jens U.
超抗原诱导的糖皮质激素不敏感导致慢性鼻窦炎伴鼻息肉复发
影响因子：
3.4
作者：
Wang, Mingming;Shi, Peng;Wang, Haibo
通讯作者：
Wang, Haibo
影响因子：
7.2
作者：
Aversa, S.;Ondolo, C.;Racca, S.
通讯作者：
Racca, S.
DOI：
10.2165/00151829-200504050-00002
发表时间：
2005-01-01
期刊：
Treatments in respiratory medicine
影响因子：
--
作者：
Brightling, Christopher E;Green, Ruth H;Pavord, Ian D
通讯作者：
Pavord, Ian D