抗IL-4Rα单克隆抗体与鼻内镜手术治疗嗜酸性粒细胞型慢性鼻窦炎伴鼻息肉的疗效分析

doi:10.6040/j.issn.1673-3770.0.2024.093

Abstract

Abstract: Objective To observe and analyse the short-term efficacy of anti-IL-4Rα monoclonal antibody and endoscopic sinus surgery(ESS)in the treatment of eosinophilic chronic rhinosinusitis with nasal polyps(ECRSwNP). Methods Twenty-one patients diagnosed with bilateral ECRSwNP were treated with endoscopic sinus surgery(surgery group), anti-IL-4Rα monoclonal antibody(monoclonal antibody group)and intranasal corticosteroids(control group)respectively. To observe the difference in subjective and objective scores after treatment at 1 month, 3 months and 6 months compared with baseline, to evaluate the therapeutic effect of the two interventions, and then the efficacy of each group was compared to analyse whether there were differences. Results Nasal polyp scores(NPS), sino-nasal outcome test-22(SNOT-22)score, SNOT-22 nasal obstruction score and olfactory score, and Lund-Mackay score at 6 months post-treatment in monoclonal antibody group and surgery group were compared with the baseline data before treatment. The differences were statistically significant(P<0.05). There was a statistically significant difference in NPS(P=0.02), and no significant difference in SNOT-22(P=0.57), nasal obstruction score(P=0.94), olfactory score(P=0.11)and Lund-Mackay score(P=0.08)between monoclonal antibody group and surgery group. There were statistically significant differences in FEV1%(P=0.04)and FEV1/FVC%(P=0.01)in monoclonal antibody group and surgery group before and after treatment in patients with comorbid asthma, but there was no significant difference between the two groups(P=0.25, P=0.74).There was no statistically significant difference in changes in eosinophil count(F=1.73, P=0.21)and eosinophil percentage(F=0.03, P=0.87)before and after treatment among the three groups. The differences between the three were not significant(P=0.18, P=0.07). Conclusion Both anti-IL-4Rα monoclonal antibodies and endoscopic sinus surgery can not only significantly improve nasal symptoms, olfactory levels, and lung function in patients with ECRSwNP, but also reduce the extent of sinusitis lesions and improve patients' quality of life. Olfactory improvement in anti-IL-4Rα monoclonal antibody patients was more significant than in ESS patients, while polyp burden and nasal symptoms were significantly improved in ESS patients.

Key words: Anti-IL-4Rα monoclonal antibody, Endoscopic sinus surgery, Eosinophilic chronic rhinosinusitis with nasal polyps, Glucocorticoid

CLC Number:

R765.9

CHEN Xingxue, ZHANG Guangling, WU Tianyi, WANG Weiwei, SUN Zhanwei, LI Shichao, WANG Guangke. Analysis of anti-IL-4Rα monoclonal antibody and endoscopic sinus surgery in the treatment of eosinophilic chronic rhinosinusitis with nasal polyps[J].Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(4): 43-54.

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Analysis of anti-IL-4Rα monoclonal antibody and endoscopic sinus surgery in the treatment of eosinophilic chronic rhinosinusitis with nasal polyps

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