Comparison of subjective and objective assessment of glucocorticoid response in nasal polyps: a preliminary study
Comparison of subjective and objective assessment of glucocorticoid response in nasal polyps: a preliminary study
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鼻息肉糖皮质激素反应的主客观评估比较：初步研究
DOI：
10.1080/00016489.2018.1541507
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发表时间：
2019
影响因子：
1.4
通讯作者：
Sun Yueqi
中科院分区：
文献类型：
--
作者：
Zheng Rui;Wang Kai;Yang Qintai;Chen Yang;Wang Dan;Gao Wenxiang;Zhou Min;Cao Yu Jie;Shi Jianbo;Sun Yueqi
摘要背景：糖皮质激素(GC)对慢性鼻窦炎鼻息肉(CRSwNP)的疗效差异显著。目的/目的：比较主观和客观的GC敏感性评估在反映GC对CRSwNP患者全身和局部嗜酸性粒细胞增多的影响方面的效用。材料和方法：纳入26例CRSwNP患者。所有患者服用泼尼松30 mg，每日1次，连续7天，随后分为主观GC敏感和不敏感亚组或客观GC敏感和不敏感亚组。比较GC敏感亚组和GC不敏感亚组血液和息肉组织中嗜酸性粒细胞和中性粒细胞的数量。结果：17/26(65.4%)患者主观上对GC治疗敏感，8/26(30.8%)患者客观上对GC治疗敏感。GC敏感和不敏感患者经GC治疗后，血中嗜酸性粒细胞的绝对数和百分率均降低。此外，只有在GC治疗后，客观上对GC敏感的受试者才能观察到组织中嗜酸性粒细胞百分比的显著减少。此外，客观上对GC敏感的受试者组织中嗜酸性粒细胞百分比的变化明显高于客观上不敏感的受试者。结论和意义：在CRSwNP患者中，客观评估可能比主观评估更好地反映组织嗜酸性炎症患者的口服GC反应。
Abstract Background: Glucocorticoids (GC) therapeutic response in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) varies markedly. Aims/Objectives: To compare the utility between subjective and objective assessment of GC sensitivity in reflecting the impact of GC on systemic and local eosinophilia in CRSwNP patients. Material and methods: Twenty-six patients with CRSwNP were enrolled. All patients were given 30 mg of prednisone once daily for 7 days and subsequently classified into subjectively GC-sensitive and -insensitive subgroup or objectively GC-sensitive and -insensitive subgroup. The numbers of eosinophils and neutrophils in blood and polyp tissues were compared between GC-sensitive and GC-insensitive subgroup. Results: 17/26 (65.4%) patients were subjectively and 8/26 (30.8%) patients objectively sensitive to GC treatment. The absolute number and percentage of eosinophils in blood were decreased both in GC-sensitive and -insensitive subjects after GC treatment. In addition, a significant reduction in tissue eosinophil percentage was only observed in objectively GC-sensitive subjects after GC treatment. Furthermore, the change of tissue eosinophil percentage in objectively GC-sensitive subjects was significantly higher than that in objectively GC-insensitive subjects. Conclusions and significance: Objective assessment may better reflect oral GC response in tissue eosinophilic inflammation than subjective assessment in patients with CRSwNP.