Definition and characteristics of acute exacerbation in adult patients with chronic rhinosinusitis: a systematic review
Definition and characteristics of acute exacerbation in adult patients with chronic rhinosinusitis: a systematic review
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成人慢性鼻窦炎急性加重的定义和特征：系统评价
DOI：
10.1186/s40463-020-00459-w
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发表时间：
2020-08
期刊：
影响因子：
--
通讯作者：
魏永祥
中科院分区：
文献类型：
--
作者：
武大伟;Benjamin Bleier;魏永祥
背景：慢性鼻窦炎（CRS）的急性加重（AE）已经越来越被认为是一个重要的临床问题。本研究的目的是总结目前AE的定义和评价参数，进而识别和量化CRS AE的临床和免疫病理特征。方法对PubMed、Scopus和Cochrane数据库1990年1月至2020年8月的文献进行系统回顾，以确定与CRS中AE相关的研究。排除标准包括非英语和非人类研究以及病例报告。结果所有研究均以短期恶化的鼻窦症状为基础，对CRS中AE的定义。使用患者报告的前3个月至1年的鼻窦感染和加重相关的药物治疗来评估CRS中AE的频率。22项鼻结果测试（SNOT-22）评分在加重期间相对于基线平均下降7.83分。共病哮喘、SNOT-22评分≥24、变应性鼻炎、嗜酸性粒细胞计数≥150/μL和自身免疫性疾病与CRS加重倾向表型呈正相关。慢性鼻窦炎伴鼻息肉（CRSwNP）患者AE与粘液细胞因子包括髓过氧化物酶（百分比升高[PI] = 101%）、IL-5 （PI = 125%）和IL-6 （PI = 162%）表达升高相关，可通过粘液胱抑素和骨膜蛋白升高预测。结论CRS中AE的定义在很大程度上取决于患者自述的症状，并与多种危险因素相关。CRSwNP中与AE相关的粘液细胞因子的定量变化可用于预测事件。在CRS中制定一致的AE定义对于帮助确定疾病控制和治疗效果至关重要。
BackgroundAcute exacerbations (AE) in chronic rhinosinusitis (CRS) have been increasingly recognized as an important clinical issue. The purpose of this study is to summarize the current definitions and evaluation parameters of AE and then identify and quantify the clinical and immunopathologic characteristics of AE in CRS.MethodsA systematic review of the literature was performed on PubMed, Scopus, and Cochrane databases from January 1990 through August 2020 to identify studies relating to AE in CRS. Exclusion criteria included non-English and non-human studies, and case reports.ResultsThe definitions of AE in CRS among all the studies were based on a description of short-term worsening sinonasal symptoms. Patient-reported sinus infection and exacerbation related medical treatment during the preceding 3 months to 1 year were used to evaluate the frequency of AE in CRS. The average decline in 22-item Sino-Nasal Outcome Test (SNOT-22) score during an exacerbation was 7.83 points relative to baseline. Comorbid asthma, SNOT-22 scores ≥24, allergic rhinitis, eosinophil count ≥150/μL and autoimmune disease were positively associated with an exacerbation-prone CRS phenotype. AE in chronic rhinosinusitis with nasal polyps (CRSwNP) was associated with increased expression of mucus cytokines including myeloperoxidase (percentage increase [PI] = 101%), IL-5 (PI = 125%), and IL-6 (PI = 162%) and could be predicted by the increasing mucus cystatin and periostin.ConclusionThe definition of AE in CRS is largely driven by patient-reported symptoms and is associated with several risk factors. Quantitative changes in mucus cytokines associated with AE in CRSwNP and may be used to predict events. The development of a consistent definition of AE in CRS is critical to help define disease control and treatment efficacy.
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影响因子：
5.3
作者：
通讯作者：
--
影响因子：
6.4
作者：
Ramakrishnan VR;Mace JC;Soler ZM;Smith TL
通讯作者：
Smith TL
DOI：
10.1172/jci118431
发表时间：
1996-01
期刊：
The Journal of clinical investigation
影响因子：
--
作者：
Zhou Zhu;Weiliang Tang;A. Ray;Yang Wu;O. Einarsson;M. Landry;J. Gwaltney;J. Elias
通讯作者：
Zhou Zhu;Weiliang Tang;A. Ray;Yang Wu;O. Einarsson;M. Landry;J. Gwaltney;J. Elias
影响因子：
4.6
作者：
Ninomiya T;Noguchi E;Haruna T;Hasegawa M;Yoshida T;Yamashita Y;Okano M;Yoshida N;Haruna S;Sakuma Y;Ohta S;Ono J;Izuhara K;Okada M;Kidoguchi M;Tokunaga T;Okamoto M;Kanno M;Sakashita M;Takabayashi T;Narita N;Fujieda S
通讯作者：
Fujieda S
影响因子：
3.4
作者：
Lanza, DC;Kennedy, DW
通讯作者：
Kennedy, DW