慢性鼻窦炎伴鼻息肉与哮喘的相关性机制及治疗策略研究进展

慢性鼻窦炎伴鼻息肉(CRSwNP)和哮喘作为上下呼吸道最具代表性的慢性炎症性疾病，二者在发病过程中常相互并存，临床诊治棘手。目前对CRSwNP和哮喘的相互作用机制尚未阐明。欧洲鼻窦炎鼻息肉诊疗指南(EPOS 2012)对治疗CRSwNP伴或不伴哮喘已给出具体的指导意见，其常规治疗包括鼻用糖皮质激素、生理盐水洗鼻等，并进一步根据CRSwNP的特点、症状严重程度等进行后续的联合治疗。据报道，鼻窦手术和药物治疗CRSwNP对合并支气管哮喘的转归有益。但CRSwNP合并哮喘患者经药物与手术治疗后的疗效判定尚缺乏足够的随机对照试验证据。

Advances in interaction mechanisms and treatment strategy between chronic rhinosinusitis with nasal polyp and asthma

Chronic rhinosinusitis with nasal polyp (CRSwNP) and asthma are representative chronic inflammatory diseases, which often coexist in the upper and lower airways. It is difficult to perform an effective therapy for patients with CRSwNP accompanied by asthma because interaction mechanisms and therapeutic effects after medical treatment and endoscopic sinus surgery remain unclear. The European position paper on rhinosinusitis and nasal polyps 2012 (EPOS 2012) presents detailed guidelines on the therapy of CRSwNP with or without asthma, including intranasal corticosteroids, nasal irrigation with saline, and so on. In addition, comprehensive follow-up treatments need to be performed according to the feature and severity of symptoms of CRSwNP. Research shows that it is beneficial for improving the prognosis of patients with CRSwNP accompanied by asthma by combining sinus surgery with medical treatment, but further randomized clinical trials are needed to better understand the management of asthma accompanied by CRSwNP.