14例阿司匹林耐受不良三联征临床分析
作者:
基金项目:

国家耳鼻喉咽喉疾病临床医学研究中心开放课题项目(202100003)。


Clinical analysis of 14 patients with aspirin intolerance triad
Author:
  • JIN Yingyu

    JIN Yingyu

    Department of Otolaryngology Head and Neck Surgery, the Fourth Medical Center of the Peoples Liberation Army General Hospital, Beijing 100142;Department of Otolaryngology Head and Neck Surgery, the Sixth Medical Center of the Peoples Liberation Army General Hospital, Beijing 100048;National Otolaryngology Head and Neck Surgery Research Center, Beijing 100142, China
    在知网中查找
    在百度中查找
    在本站中查找
  • HAN Zeli

    HAN Zeli

    Department of Otolaryngology Head and Neck Surgery, the Fourth Medical Center of the Peoples Liberation Army General Hospital, Beijing 100142;Department of Otolaryngology Head and Neck Surgery, the Sixth Medical Center of the Peoples Liberation Army General Hospital, Beijing 100048;National Otolaryngology Head and Neck Surgery Research Center, Beijing 100142, China
    在知网中查找
    在百度中查找
    在本站中查找
  • 摘要
  • | |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • | |
    摘要:

    目的 探讨阿司匹林耐受不良三联征(AIT)的临床特点,治疗方法,总结最新诊疗经验。方法 采用回顾性研究方法, 对14例AIT患者的用药特点、临床特点、鼻窦CT、鼻镜、鼻腔鼻窦手术史等结果及治疗情况进行统计分析,并进行相关文献复习。结果 14例患者中1例患者因哮喘急性发作,经术前评估后暂缓手术治疗;13例患者行手术治疗,术后6个月随访,其中11例未见复发,病情基本得到控制;2例患者鼻部症状复发,1例再次行手术治疗,另1例继续药物综合治疗。结论 AIT因其伴有哮喘及相关药物过敏情况,鼻窦炎症状较重,多为全组鼻窦炎,易复发,远期失嗅,早期临床多误诊。能够早期明确诊断,早期围术期规范用药,早期进行彻底清除病灶,并进行规律术后药物治疗是本病的治疗关键。

    Abstract:

    Objective To explore the clinical characteristics and treatment methods of aspirin intolerance triad (AIT), summarize the cutting-edge research at home and abroad, and summarize the latest diagnosis and treatment experience.Methods A retrospective study was conducted to analyze the medication characteristics, clinical features, sinus CT, nasal endoscopy, history of nasal and sinus surgery, and treatment status of 14 AIT patients. Relevant literature was reviewed.Results One of 14 patients had an acute attack of asthma, and the operation was postponed after preoperative evaluation;11 cases of 14 patients were followed up for 6 months without recurrence, and the condition was basically under control; 2 patients of 14 patients had recurrent nasal symptoms, one of them underwent surgery again, and the other one continued drug combination therapy.Conclusions Due to its accompanying asthma and related drug allergies, AIT has severe symptoms of sinusitis, which is mostly a complete group of sinusitis, prone to recurrence, long-term loss of smell, and early clinical misdiagnosis.The key to the treatment of this disease is to have a clear diagnosis in the early stage, standardize medication during the perioperative period, thoroughly remove the lesion in the early stage, and provide regular postoperative medication treatment.

    网友评论
    网友评论
    分享到微博
    发 布
    参考文献
    [1] Widal F, Abrami P, Lermoyez J. First complete description of the aspirin idiosyncrasy-asthma-nasal polyposis syndrome (plus urticaria):1922 (with a note on aspirin desensitization)[J]. Asthma, 1987, 24(5):297-300.
    [2] Samter M, Beers RF Jr. Intolerance to aspirin. clinical studies and consideration of its pathogenesis[J]. Ann Intern Med, 1968, 68(5):975-983.
    [3] Esmaeilzedeh H,Esmaeilzedeh E,Faramarzi M,et al.Salicylate food intolerance and aspirin hypersensitivity in nasal polyposis[J].Iran J Immunol, 2017, 14(1):81-88.
    [4] San nicoló M,Högerle C,Gellrich D,et al.The time course of nasal cytokine secretion in patients with aspirin-exacerbated respiratory disease(AERD) undergoing aspirin desensitization:preliminary data[J].Eur Arch Otorhinolaryngol, 2020, 277(2):445-452.
    [5] 金莹玉,邹艺辉,韩泽利,等.阿司匹林耐受不良三联征1例[J]. 中国耳鼻咽喉颅底外科杂志, 2023, 29(4):91-93.
    [6] Simon RA, Dazy KM, Waldram JD. Aspirin-exacerbated respiratory disease:characteristics and management strategies[J]. Expert Rev Clin Immunol, 2015, 11(7):805-817.
    [7] 顾之燕. 阿司匹林耐受不良——鼻炎,鼻窦炎,鼻息肉和支气管哮喘[J]. 临床耳鼻咽喉科杂志, 2000, 14(8):381-383.
    [8] Lund VJ,Mackay IS.Staging in rhinosinusitis[J].Rhinology, 1993, 31(4):183-184.
    [9] Lund VJ,Kenedy DW. Staging for thinosinusitis[J]. Otolaryngol Head Neek Surg, 1997, 117(3 Pt 2):S35-40.
    [10] Alsharif S,Jonstam K,van Zele T,et al.Endoscopic sinus surgery for type-2 CRS wNP:an endotype-based retrospective study[J].Laryngoscope, 2019, 129(6):1286-1292.
    [11] Stevens WW, Staudacher AG, Hulse KE, et al.Studies of the role of basophils in aspirin-exacerbated respiratory disease pathogenesis[J]. J Allergy Clin Immunol, 2021, 148(2):439-449.
    [12] 轶鹂,董震.鼻息肉病的病理机制研究进展[J].中华耳鼻咽喉科杂志, 1999, 34(3):181-183.
    [13] Szczeklik A, Nizankowska-Mogilnicka E, Duplaga M. Natural history of aspirin-induced asthma. AIANE Investigators. European Network on Aspirin-Induced Asthma[J]. Eur Respir J, 2000, 16(3):432-436.
    [14] Settipane RA,Constantine HP,Settipane GA.Aspirin intolerance and recurrent urticaria in normal adults and children. Epidemiology and review[J].Allergy, 1980, 35(2):149-154.
    [15] Iwasawa M,Sagami K,Yokoyama S,et al.Adherence to guidelines for antiulcer drug prescription in patients receiving lowdose aspirin therapy in Japan[J].Int J Clin Pharmacol Ther, 2019, 57(4):197-206.
    [16] Rajan J, Wineinger N, Stevenson D, et al. Prevalence of aspirin-exacerbated respiratory disease among asthmatic patients:A meta-analysis of the literature[J]. J Allergy Clin Immunol, 2015, 135(3):676-681.
    [17] Yip J, Yao CM, Lee JM. State of the art:A systematic review of the surgical management of aspirin exacerbated respiratory disease[J]. Am J Rhinol Allergy, 2014, 28(6):493-501.
    [18] Stevens WW, Peters AT, Hirsch AG, et al. Clinical characteristics of patients with chronic rhinosinusitis with nasal polyps, asthma, and aspirin-exacerbated respiratory disease[J]. Allergy Clin Immunol Pract, 2017, 5(4):1061-1070.
    [19] Tajudeen BA, Schwartz JS, Bosso JV. The role of aspirin desensitization in the management of aspirin exacerbated respiratory disease[J]. Curr Opin Otolaryngol Head Neck Surg, 2017, 25(1):30-34.
    [20] Bachert C, Han JK, Desrosiers M, et al. Efficacy and safety of dupilumab in patients with severe chronic rhinosinusitis with nasal polyps (LIBERTY NP SINUS-24 and LIBERTY NP SINUS-52):results from two multicentre, randomised, double-blind, placebo-controlled, parallel-group phase 3 trials[J]. Lancet, 2019, 394(10209):1638-1650.
    [21] Wautlet A, Bachert C, Desrosiers M, et al.The management of chronic rhinosinusitis with nasal polyps (CRSwNP) with biologics[J]. J Allergy Clin Immunol Pract, 2023, 11(9):2642-2651.
    [22] Ma T, Wang H, Wang X. Effectiveness and response predictors of omalizumab in treating patients with seasonal allergic rhinitis:A real-world study[J]. Asthma Allergy, 2021, 14:59-66.
    [23] Zhang Y, Xi L, Gao Y, et al. Omalizumab is effective in the preseasonal treatment of seasonal allergic rhinitis[J]. Clinical and translational allergy, 2022, 12(1):e12094.
    [24] Schneider S, Poglitsch K, Morgenstern C, et al. Dupilumab increases aspirin tolerance in NSAID-exacerbated respiratory disease (N-ERD)[J]. European Respiratory J, 2023, 61(3):2201335.
    [25] Wangberg H, Spierling Bagsic SR, Osuna L, et al. Appraisal of the real-world effectiveness of biologic therapies in aspirin-exacerbated respiratory disease[J].Allergy Clin Immunol Pract, 2022, 10(2):478-484.
    [26] Rabe KF, Nair P, Brusselle G, et al. Efficacy and safety of dupilumab in glucocorticoid-dependent severe asthma[J]. N Engl Med, 2018, 378(26):2475-2485.
    [27] Eid RC, Palumbo ML, Cahill KN.Perimenstrual asthma in aspirin-exacerbated respiratory disease[J]. Allergy Clin Immunol Pract, 2020, 8(2):573-578.
    相似文献
    引证文献
引用本文

金莹玉,韩泽利.14例阿司匹林耐受不良三联征临床分析[J].中国耳鼻咽喉颅底外科杂志,2024,30(2):106-110

复制
分享
文章指标
  • 点击次数:71
  • 下载次数: 279
历史
  • 收稿日期:2023-06-06
  • 在线发布日期: 2024-05-08
温馨提示

本刊唯一投稿网址:www.xyosbs.com
唯一办公邮箱:xyent@126.com
编辑部联系电话:0731-84327210,84327469
本刊从未委托任何单位、个人及其他网站代理征稿及办理其他业务联系,谨防上当受骗!

关闭