短期口服类固醇可显著改善无鼻息肉的慢性鼻窦炎。

The Laryngoscope Pub Date : 2021-10-01 Epub Date: 2021-03-04 DOI:10.1002/lary.29495
April P De Silva, Mark A Schembri, Angus H Sarah, Jessica Chao, Kwok Ho Yip, Gökhan Cildir, Angel Lopez, Damon J Tumes, Harshita Pant
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引用次数: 4

摘要

目的/假设:短期口服皮质类固醇治疗无鼻息肉的慢性鼻窦炎(CRSsNP)的疗效尚不清楚。本对照研究的目的是评估短期内常用口服皮质类固醇强的松龙治疗定义明确的crsssnp患者的近期和长期结果。研究设计:前瞻性、观察性对照研究。方法:一项前瞻性对照研究,以0.5 mg/kg强的松龙治疗CRSsNP患者,在10天内逐渐减少,非强的松龙治疗CRSsNP患者(对照组),并在2、6和12个月进行随访。比较基线和随访鼻窦预后测试(SNOT)-22、鼻内窥镜检查(Lund-Kennedy)和鼻窦CT扫描评分(Lund-Mackay)。结果:在2个月时,强的松龙组的SNOT-22、鼻内窥镜检查和鼻窦CT扫描评分均有显著改善(P)。结论:短期口服强的松龙可显著改善crsssnp患者的所有三项临床指标,并在前12个月内避免52.5%的患者进行手术干预。症状持续时间少于11个月的患者最有可能受益。口服类固醇的副作用需要仔细考虑,需要进一步研究以确定适当的剂量和治疗时间。证据等级:3喉镜,131:E2618-E2626, 2021。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Short-term Oral Steroids Significantly Improves Chronic Rhinosinusitis Without Nasal Polyps.

Objectives/hypothesis: The efficacy of short-term oral corticosteroids in chronic rhinosinusitis without nasal polyps (CRSsNP) is unknown. The aim of this controlled study was to assess the immediate and long-term outcomes from a short course of a commonly used oral corticosteroid, prednisolone, in well-defined CRSsNP patients.

Study design: Prospective, observational controlled study.

Methods: A prospective-controlled study of CRSsNP patients treated with prednisolone at 0.5 mg/kg tapered over 10 days and non-prednisolone treated CRSsNP patients (controls) and follow-up at 2, 6, and 12 months. Baseline and follow-up SinoNasal Outcome Test (SNOT)-22, nasal endoscopy (Lund-Kennedy), and sinus CT scan scores (Lund-Mackay) were compared.

Results: At 2 months, there was a significant improvement in the SNOT-22, nasal endoscopy, and sinus CT scan scores in the prednisolone group (P < .0001) compared with controls (p = ns, Mann-Whitney U test). 52.5% of prednisolone-treated CRSsNP patients had improved symptoms and did not require sinus surgery at 12 months compared with 14.3% of controls (P < .001). Side-effects were reported in 8.9% of prednisolone-treated patients. Patients who benefited from prednisolone had a median symptom duration of 7.25 (99% confidence, upper limit of 11) months compared with 18 months in those requiring surgery.

Conclusions: Short-term oral prednisolone significantly improved all three clinical measures of disease in CRSsNP patients and avoided surgical intervention in 52.5% patients in the first 12 months. Patients with symptoms for less than 11 months were most likely to benefit. The side-effects of oral steroids require careful consideration and further studies are needed to ascertain appropriate dosage and treatment duration.

Level of evidence: 3 Laryngoscope, 131:E2618-E2626, 2021.

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