预测在高效调节器疗法时代追求鼻手术的因素
Daniel M Beswick1, Ethan J Han1, Jess C Mace2
1Department of Head and Neck Surgery, University of California, Los Angeles, California, USA.
International forum of allergy & rhinology
|September 19, 2023
概括
患有囊性纤维化 (PwCF) 的患者接受内镜外科手术 (ESS) 通常会出现更严重的症状,并且不太可能使用调节器疗法. 通过elexacaftor/tezacaftor/ivacaftor (ETI) 治疗,减少了追求ESS的可能性.
科学领域:
- 肺部病理学 肺部病理学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 医学治疗学 医学治疗学
背景情况:
- 慢性鼻炎 (CRS) 是患有囊性纤维化 (PwCF) 的人常见的并发症.
- 高效的调节器疗法可以改善PwCF患者的生活质量,但它们对CRS及其对进行内镜外科手术 (ESS) 的决定的影响还未得到充分研究.
研究的目的:
- 调查与囊性纤维化 (PwCF) 患者选择接受内镜外科手术 (ESS) 相关的因素.
- 评估调节器疗法的影响,特别是elexacaftor/tezacaftor/ivacaftor (ETI),在PwCF与CRS的ESS的决策过程中.
主要方法:
- 一项前性,观察性,多机构研究招募了成年PwCF与CRS.
- 参与者完成了对呼吸系统症状,抑郁,睡眠质量和嗅觉的验证结果测量,以及鼻内镜,鼻腔CT扫描和嗅觉测试.
- 双变量和多变量回归分析确定了与追求ESS相关的因素.
主要成果:
- 在PwCF分析的60家公司中,有24家 (40%) 选择了ESS.
- 追求ESS与较差的鼻腔结局测试 (SNOT-22) 分数,抑郁症,睡眠功能障碍和在鼻腔内镜上更严重的疾病相关.
- 缺乏ETI治疗与追求ESS有关,而ETI使用与追求ESS的几率较低有关.
结论:
- 更糟糕的鼻症状,睡眠质量差,抑郁症和鼻腔内镜检查结果与接受ESS的决定有关.
- 肺部疾病的严重程度和鼻CT得分与ESS追求没有显著的相关性.
- ETI治疗独立地降低了PwCF追求ESS的可能性,无论鼻症状的严重程度如何.
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