Correlation of Symptoms, Clinical Signs, and Biomarkers of Inflammation in Postsurgical Chronic Rhinosinusitis
Correlation of Symptoms, Clinical Signs, and Biomarkers of Inflammation in Postsurgical Chronic Rhinosinusitis
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DOI：
10.1177/0003489417701939
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发表时间：
2017-06-01
影响因子：
1.4
通讯作者：
Ponikau, Jens U.
中科院分区：
文献类型：
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作者：
Racette, Samuel D.;Wijewickrama, Rohan C.;Ponikau, Jens U.
目的：评价慢性鼻-鼻窦炎合并息肉样改变/鼻息肉患者的症状及其与CT、鼻内窥镜和鼻内生物标志物的相关性。研究设计：前瞻性多中心研究成人慢性鼻-鼻窦炎术后症状资料与客观资料对照分析。方法：采用Logistic回归分析方法，评估258名参与者的16个问题的调查结果与鼻内窥镜评分、鼻窦阻塞的CT百分比、鼻腔真菌抗原(交链孢子菌和曲霉菌)、嗜酸性粒细胞炎症(嗜酸性粒细胞衍生神经毒素[EDN]和主要碱性蛋白[MBP])的相关性结果：研究参与者的评估显示，在表现出更强的嗅觉障碍的参与者中，CT闭塞增加(P<；.019)。鼻内窥镜检查发现粘膜炎症与充血(P<；.028)、流鼻水(P<；.002)和耳痛(P<；.007)呈正相关。伴有烦人充血(P<；.031)和流鼻水(P<；.011)的患者EDN升高呈正相关。打喷嚏与多种标志物呈正相关：交链孢霉(P<；0.024)、白介素13(P<；0.027)、MBP(P<；0.034)和白介素5(P<；0.019)。结论：鼻内窥镜检查而不是CT检查与CRS患者充血和流鼻水这两个主要症状的相关性最强；这些与嗜酸性炎症的生物标志物相关。
Objective: The study aimed to evaluate symptoms described by patients with chronic rhinosinusitis with polypoid changes/nasal polyps and their correlation with computed tomography (CT), nasal endoscopy, and intranasal biomarkers.Study Design: Prospective multicenter study symptom data from postsurgical adult chronic rhinosinusitis study participants with recurrent disease refractory to medical therapy were analyzed in comparison with objective data.Methods: Using logistic regression analysis, participant-rated 16-question surveys from 258 participants were assessed for correlation with nasal endoscopy scores, CT percentage of sinus occlusion, and intranasal biomarkers of fungal antigens (Alternaria and Aspergillus), eosinophilic inflammation (eosinophil-derived neurotoxin [ EDN] and major basic protein [ MBP]), and inflammatory cytokines (interleukins 5 and 13).Results: Study participant assessments revealed increased CT occlusion in participants presenting with greater inability to smell (P < .019). Mucosal inflammation identified on nasal endoscopy was positively correlated with congestion (P < .028), runny nose (P < .002), and ear pain (P < .007). Elevated EDN was positively correlated in patients with bothersome congestion (P < .031) and runny nose (P < .011). Sneezing was positively correlated with multiple markers: Alternaria (P < .024), interleukin-13 (P < .027), MBP (P < .034), and interleukin- 5 (P < .019).Conclusion: Nasal endoscopy, not CT imaging, has the strongest correlation with the 2 cardinal symptoms of congestion and runny nose in CRS patients; these correlate with biomarkers of eosinophilic inflammation.