浅谈伴有变应性鼻炎的慢性鼻窦炎的治疗

doi:10.6040/j.issn.1673-3770.1.2018.007

摘要/Abstract

摘要： 慢性鼻窦炎和变应性鼻炎是两种常见的慢性上呼吸道疾病,存在着某些内在联系以及类似炎症机制。有必要完善慢性鼻窦炎、鼻息肉患者的术前变态反应检查以及治疗:包括避免过敏原(环境和食物)、免疫治疗、鼻腔冲洗、鼻用糖皮质激素、针对鼻窦病原体的抗菌药物、抗变态反应(抗组胺药、白三烯受体拮抗剂等)和抗胃食管反流。此外,维生素D诱导细胞分化、参加免疫调节和调节内分泌系统也在慢性鼻窦炎和变应性鼻炎的炎症过程中发挥重要作用。

关键词: 鼻窦炎慢性, 变应性鼻炎, 免疫治疗, 维生素D, 胃食管反流

Abstract: Chronic rhinosinusitis(CRS)and allergic rhinitis(AR)are both common chronic upper respiratory diseases and they have certain inherent links and similar inflammatory mechanisms. It is necessary to improve preoperative examination and treatment of allergies in patients with chronic sinusitis or nasal polyps including through food and environment allergen avoidance, immunotherapy, nasal irrigation, administration of nasal steroid hormones, antibiotics against sinus pathogens, and anti-allergy medications such as antihistamines and leukotriene receptor antagonists; and anti-gastroesophageal reflux surgery. Furthermore, vitamin D induces cell differentiation, participates in immune regulation, and regulates other endocrine systems, thus playing an important role in the inflammation involved in CRS and AR.

Key words: Allergic rhinitis, Gastroesophageal reflux, Vitamin D, Rhinosinusitis, chronic, Immunotherapy

中图分类号:

R765.4

陈鸣,俞雪飞. 浅谈伴有变应性鼻炎的慢性鼻窦炎的治疗[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 18-22.

CHEN Ming, YU Xuefei. Opinions on the treatment of chronic rhinosinusitis with allergic rhinitis[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2018, 32(3): 18-22.

参考文献

[1] Lin SY, Reh DD, Navas-Acien A. Allergic rhinitis, chronic rhinosinusitis, and symptom severity: a population-based study[J]. Int Forum Allergy Rhinol, 2012, 2(1):51-56.
[2] 张罗. 慢性鼻-鼻窦炎诊治将进入精准医疗时代[J]. 中华耳鼻咽喉科头颈外科杂志, 2016, 51(3):161-163. ZHANG Luo. Management of chronic rhinosinusitis: on the path to precision medicine[J]. Chin J Otorhinolaryngol Head Neck Surg, 2016, 51(3):161-163.
[3] Larsen K, Tos M. The estimated incidence of symptomatic nasal polyps[J]. Acta Otolaryngol, 2002, 122(2):179-182.
[4] Wang XD, Zheng M, Lou HF, et al. An increased prevalence of self-reported allergic rhinitis in major Chinese cities from 2005 to 2011[J]. Allergy, 2016, 71(8):1170-1180.
[5] Veling MC. The role of allergy in pediatric rhinosinusitis[J]. Curr Opin Otolaryngol Head Neck Surg, 2013, 21(3):271-276.
[6] Scheckenbach K, Wagenmann M. Cytokine patterns and endotypes in acute and chronic rhinosinusitis[J]. Curr Allergy Asthma Rep, 2016, 16(1):3.
[7] Baroody FM. Allergic rhinitis:broader disease effects and implications for management[J]. Otolaryngol Head Neck Surg, 2003, 128(5):616-631.
[8] Hughes RG, Jones NS. The role of nasal endoscopy in outpatient management[J]. Clin Otolaryngol Allied Sci, 1998, 23(3):224-226.
[9] 上官诚芳, 王士礼, 蔡昌枰. 变应性鼻炎、鼻及鼻窦炎与哮喘治疗及预后[J]. 国际耳鼻咽喉科头颈外科杂志, 2008, 32(5):292-294.
[10] Benninger MS. Rhinitis, sinusitis and their relationships to allergies[J]. American Journal of Rhinology, 1992, 6(2):37-43.
[11] Sedaghat AR, Gray ST, Wilke CO, et al. Risk factors for development of chronic rhinosinusitis in patients with allergic rhinitis[J]. Int Forum Allergy Rhinol, 2012, 2(5):370-375.
[12] Karlsson G, Holmberg K. Does allergic rhinitis predispose to sinusitis?[J]. Acta Otolaryngol Suppl, 1994, 515:26-28.
[13] Yea SS, Yang YI, Park SK, et al. Interleukin-4 C-590T polymorphism is associated with protection against nasal polyps in a Korean population[J]. Am J Rhinol, 2006, 20(5):550-553.
[14] Emanuel IA, Shah SB. Chronic rhinosinusitis:allergy and sinus computed tomography relationships[J]. Otolaryngol Head Neck Surg, 2000, 123(6):687-691.
[15] Fokkens WJ, Lund VJ, Mullol J, et al. European position paper on rhinosinusitis and nasal polyps 2012[J]. Rhinol Suppl, 2012, 23:3.
[16] Baroody FM, Mucha SM, Detineo M, et al. Nasal challenge with allergen leads to maxillary sinus inflammation[J]. J Allergy ClinImmunol, 2008, 121(5):1126-1132.
[17] 武大伟, 王建亭. 变应性联合气道疾病[J]. 国际耳鼻咽喉科头颈外科杂志, 2014,38(5):304-308.
[18] De Greve G, Hellings PW, Fokkens WJ, et al. Endotype-driven treatment in chronic upper airway diseases[J]. Clin Transl Allergy, 2017, 7(1):22.
[19] Soyka MB, Wawrzyniak P, Eiwegger T, et al. Defective epithelial barrier in chronic rhinosinusitis: the regulation of tight junctions by IFN-γ and IL-4[J]. J Allergy Clin Immunol, 2012, 130(5):1087-1096.
[20] Bachert C, Zhang N. Chronic rhinosinusitis and asthma:novel understanding of the role of IgE‘above atopy’[J]. J Intern Med, 2012, 272(2):133-143.
[21] Stevens WW, Ocampo CJ, Berdnikovs S, et al. Cytokines in chronic rhinosinusitis. Role in eosinophilia and aspirin-exacerbated respiratory disease[J]. Am J Respir Crit Care Med, 2015, 192(6):682-694.
[22] Badr DT, Gaffin JM, Phipatanakul W. Pediatric rhinosinusitis[J]. Curr Treat Options Allergy, 2016, 3(3):268-281.
[23] De Schryver E, Devuyst L, Derycke L, et al. Local immunoglobulin e in the nasal mucosa:clinical implications[J]. Allergy Asthma Immunol Res, 2015, 7(4):321-331.
[24] Rosati MG, Peters AT. Relationships among allergic rhinitis, asthma, and chronic rhinosinusitis[J]. Am J Rhinol Allergy, 2016, 30(1):44-47.
[25] Asakura K, Kojima T, Shirasaki H, et al. Evaluation of the effects of antigen specific immunotherapy on chronic sinusitis in children with allergy[J]. Auris Narus Larynx, 1990, 17(1):33-38.
[26] Nathan RA, Santilli J, Rockwell W, et al. Effectiveness of immunotherapy for recurring sinusitis associated with allergic rhinitis as assessed by the Sinusitis Outcomes Questionnaire[J]. Ann Allergy Asthma Immunol, 2004, 92(6):668-672.
[27] De Young K, Wentzel JL, Schlosser RJ, et al. Systematic review of immunotherapy for chronic rhinosinusitis[J]. Am J Rhinol Allergy, 2014, 28(2):145-150.
[28] Rabago D, Guerard E, Bukstein D. Nasal irrigation for chronic sinus symptoms in patients with allergic rhinitis, asthma, and nasal polyposis: a hypothesis generating study[J]. WMJ, 2008, 107(2):69-75.
[29] Principi N, Esposito S. Nasal irrigation: an imprecisely defined medical procedure[J]. Int J Environ Res Public Health, 2017, 14(5):516.
[30] 程雷. 抗过敏药物在慢性鼻-鼻窦炎治疗中的应用[J]. 中华耳鼻咽喉科头颈外科杂志, 2013,48(2):107-108.
[31] Oakley GM, Harvey RJ, Lund VJ. The role of macrolides in chronic rhinosinusitis(crssnp and crswnp)[J]. Curr Allergy Asthma Rep, 2017, 17(5):30.
[32] Videler WJ, van Hee K, Reinartz SM, et al. Long-term low-dose antibiotics in recalcitrant chronic rhinosinusitis:a retrospective analysis[J]. Rhinology, 2012, 50(1):45-55.
[33] Mahdavinia M, Bishehsari F, Hayat W, et al. Prevalence of allergic rhinitis and asthma in patients with chronic rhinosinusitis and gastroesophageal reflux disease[J]. Ann Allergy Asthma Immunol, 2016, 117(2):158-162.
[34] Tian HQ, Cheng L. The role of vitamin D in allergic rhinitis[J]. Asia Pac Allergy, 2017, 7(2):65-73.
[35] Akbar NA, Zacharek MA. Vitamin D:immunomodulation of asthma, allergic rhinitis, and chronic rhinosinusitis[J]. Curr Opin Otolaryngol Head Neck Surg, 2011, 19(3):224-228.
[36] Abuzeid WM, Akbar NA, Zacharek MA. Vitamin D and chronic rhinitis[J]. Curr Opin Allergy Clin Immunol, 2012, 12(1):13-17.
[37] 程雷, 钱俊俊, 田惠琴. 变应性鼻炎研究的若干进展[J]. 山东大学耳鼻喉眼学报, 2017, 31(3):1-2. CHENG Lei, QIAN Junjun, TIAN Huiqin. Research progresses on allergic rhinitis[J]. J Otolaryngol Ophthalmol Shandong Univ, 2017, 31(3):1-2.

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