低剂量度普利尤单抗应用于慢性鼻窦炎伴鼻息肉合并哮喘患者鼻内镜术后的疗效分析OA
Efficacy of low-dose Dupilumab in postoperative management of chronic rhinosinusitis with nasal polyps and comorbid asthma after endoscopic sinus surgery
目的 探讨度普利尤单抗在嗜酸性慢性鼻窦炎伴鼻息肉(eosinophilic chronic rhinosinusitis with nasal polyps,ECRSwNP)合并哮喘患者鼻内镜手术后的短期应用疗效.方法 本研究为前瞻性队列研究,纳入符合ECRSwNP合并哮喘患者40例.所有患者均行内镜鼻窦手术,试验组于术后1周内注射度普利尤单抗(300 mg),后续每月注射1次,共注射4次.对照组术后未使用任何生物制剂.两组接受相同的术后标准基础治疗.观察两组患者术后3个月及6个月后的主观、客观评分指标变化情况.结果 在术后3个月和术后6个月随访时间点,试验组患者的症状视觉模拟量表评分、鼻腔鼻窦结局测试22条总分及内镜评分、CT评分、肺功能指标以及血嗜酸性粒细胞、经口呼出气一氧化氮等2型炎症标志物显著优于对照组患者(P均<0.05).结论 在鼻内镜手术后早期联合应用度普利尤单抗3个月,能有效抑制2型炎症反应,显著改善术后6个月患者的主观症状与客观体征,降低2型炎症生物标志物水平,为ECRSwNP合并哮喘患者的术后综合管理提供新的有效策略.
OBJECTIVE To investigate the short-term efficacy of Dupilumab in patients with eosinophilic chronic rhinosinusitis with nasal polyps(ECRSwNP)and comorbid asthma following endoscopic sinus surgery.METHODS This prospective cohort study enrolled 40 patients who met the diagnostic criteria for ECRSwNP with asthma and underwent endoscopic sinus surgery.All patients underwent endoscopic sinus surgery.The experimental group received an initial subcutaneous injection of Dupilumab(300 mg)within 1 week postoperatively,followed by monthly injections for a total of 4 doses,while the control group received no biologics after surgery.Both groups received identical postoperative basic treatment.Subjective and objective outcome measures were assessed at 3 and 6 months postoperatively.RESULTS At 3 and 6 months postoperatively,the experimental group demonstrated significantly better VAS scores for nasal obstruction,rhinorrhea,and olfaction,total SNOT-22 scores,endoscopic scores,CT scores,pulmonary function parameters,and type 2 inflammatory biomarkers compared with the control group(all P<0.05).CONCLUSION Early postoperative administration of Dupilumab for 3 months following endoscopic sinus surgery can effectively suppress type 2 inflammatory responses,significantly improve subjective symptoms and objective signs at 6 months postoperatively,reduce type 2 inflammatory biomarker levels,and provides a novel and effective strategy for the comprehensive postoperative management of patients with ECRSwNP and comorbid asthma.
王威清;康天惠;杨腾裕;朱真真;吕威
中国医学科学院北京协和医学院北京协和医院耳鼻咽喉科,北京 100730中国医学科学院北京协和医学院北京协和医院耳鼻咽喉科,北京 100730中国医学科学院北京协和医学院北京协和医院耳鼻咽喉科,北京 100730中国医学科学院北京协和医学院北京协和医院耳鼻咽喉科,北京 100730中国医学科学院北京协和医学院北京协和医院耳鼻咽喉科,北京 100730
鼻窦炎鼻息肉哮喘症度普利尤单抗鼻内镜手术
SinusitisNasal PolypsAsthmaDupilumabendoscopic sinus surgery
《中国耳鼻咽喉头颈外科》 2026 (5)
260-264,5
中国医学科学院医学与健康科技创新工程项目(2025-I2M-C&T-B-012)北京协和医院人才培育支持计划C类项目(UBJ11986)北京协和医院中央高水平医院临床科研专项(2025-PUMCH-C-031)北京市自然科学基金(7252107)国家自然科学基金(82301288)
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