奥马珠单抗治疗慢性鼻窦炎伴鼻息肉合并哮喘患者的疗效研究

Efficacy of omalizumab in the treatment of chronic rhinosinusitis with nasal polyp complicated with asthma

目的探讨奥马珠单抗治疗CRSwNP合并哮喘的临床疗效。方法纳入2020年1月~2021年6月就诊于首都医科大学附属北京朝阳医院的CRSwNP合并哮喘患者29例,其中男性14例,女性15例。所有患者使用鼻用糖皮质激素和哮喘相关用药12周后加用奥马珠单抗治疗,连续使用16周并完成随访。检测奥马珠单抗治疗前及连续16周治疗后以下指标的变化:鼻内镜下鼻息肉评分、VAS评分、SNOT 22评分、Lund-Mackay评分、ACT评分、血IgE值、血嗜酸性粒细胞比例、血嗜酸性粒细胞绝对值、FeNO、FEV1和PEF。结果经过连续16周奥马珠单抗皮下注射治疗,CRSwNP合并哮喘患者鼻内镜下鼻息肉评分较治疗前降低,差异具有显著性(P<0.05);VAS评分较治疗前降低,差异具有显著性(P<0.05);SNOT-22评分、鼻窦CT评分、血IgE值、嗜酸性粒细胞比例、嗜酸性粒细胞绝对值、FeNO值较治疗前明显降低,差异具有显著性(P<0.05);ACT评分、FEV1和PEF值较治疗前改善,差异具有显著性(P<0.05)。结论奥马珠单抗联合鼻用糖皮质激素连续治疗16周后,CRSwNP合并哮喘患者的症状明显缓解,相关客观指标较前明显改善。

Objective To explore the clinical efficacy of Omalizumab in the treatment of CRSwNP complicated with asthma.Methods This study included 29 patients with CRSwNP complicated with asthma in Beijing Chaoyang Hospital Affiliated to Capital Medical University from January 2020 to June 2021,including 14 males and 15 females.All patients after 12 weeks of intranasal glucocorticoid and basic asthma medication were added omalizumab treatment for 16 weeks and follow-up.The changes of the following indexes were detected before and after 16 weeks of treatment with omalizumab:The total nasal endoscopic polyp score,VAS score,SNOT-22 score,Lund Mackay score,ACT score,blood IgE value,blood eosinophil ratio,absolute value of blood eosinophil,FEV1,PEF and FeNO.Results After 16 weeks of subcutaneous injection of omalizumab,the total nasal endoscopic polyp score in patients with CRSwNP complicated with asthma was significantly lower than that before treatment(P<0.05).The VAS scores were significantly lower than those before treatment(P<0.05).The score of SNOT-22,The CT score of paranasal sinus,the blood IgE value,the proportion of eosinophils,the absolute value of eosinophils and the FeNO were significantly lower than that before treatment(P<0.05).The score of ACT,FEV1 and PEF were significantly improved compared with those before treatment(P<0.05).Conclusion After 16 weeks treatment of Omalizumab combined with intranasal glucocorticoid,the symptoms of patients with CRSwNP complicated with asthma were significantly relieved,and the relevant objective indexes were significantly improved.