奥马珠单抗治疗阿司匹林加重性呼吸系统疾病的临床疗效观察  

Clinical observation of omalizumab in the treatment of aspirin-exacerbated respiratory diseases

作　　者：陈子琦 张敏[1] 沈暘[1] 杨玉成[1] 洪苏玲[1] 柯霞[1] CHEN Ziqi;ZHANG Min;SHEN Hao;YANG Yucheng;HONG Suling;KE Xia(Department of Otolaryngology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院耳鼻咽喉科,重庆400016

出　　处：《中国耳鼻咽喉颅底外科杂志》2025年第1期76-81,共6页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：重庆市中青年高端人才培养项目[2020(219)];重庆医科大学未来医学青年创新团队(W0157)。

摘　　要：目的探讨奥马珠单抗治疗阿司匹林加重性呼吸系统疾病(AERD)的临床疗效及安全性。方法回顾性分析2019年1月—2023年4月在重庆医科大学附属第一医院耳鼻咽喉科接受奥马珠单抗治疗的AERD患者32例,比较治疗前后的鼻部症状视觉模拟量表(VAS)评分、鼻息肉评分(NPS)、鼻窦CT Lund-Mackay评分(LMS)、宾夕法尼亚大学嗅觉识别测试(UPSIT)评分、外周血嗜酸性粒细胞计数、呼出气一氧化氮(FeNO)、肺功能、不良反应及生活质量评分等。结果经24周奥马珠单抗治疗后,患者流涕及头面部胀痛VAS评分无明显改善,鼻塞及嗅觉减退VAS评分下降、UPSIT评分明显升高(P<0.05),提示鼻部症状改善。治疗后NPS、LMS及汉化版鼻腔鼻窦结局测试22条(SNOT-22)评分均有明显降低(P<0.05),提示鼻窦炎症明显控制,生活质量改善。患者治疗后肺通气功能改善、FeNO下降、哮喘控制测试(ACT)评分升高,提示下气道炎症控制、症状显著改善(P<0.05)。治疗后外周血嗜酸性粒细胞绝对值明显下降(P<0.05)。270次注射中不良反应为0.3%,提示安全性良好。结论应用奥马珠单抗能有效控制AERD上下气道炎症,疗效可靠,可有效改善患者生活质量,安全性良好。Objective To explore the clinical efficacy and safety of omalizumab in the treatment of aspirin-aggravated respiratory diseases(AERD).Methods A retrospective analysis was performed on 32 AERD patients who received omalizumab in the department of otolaryngology,the first affiliated hospital of Chongqing medical university from January 2019 to April 2023.Visual analogue scale(VAS)score of nasal symptoms,nasal polyp score(NPS),sinus CT Lund-Mackay score(LMS),University of Pennsylvania olfactory recognition test(UPSIT)score,peripheral blood eosinophilic count,exhaled nitric oxide(FeNO),pulmonary function and adverse reactions,quality of life score before and after treatment were compared.Results After 24 weeks of omalizumab treatment,the VAS scores of runny nose and head and facial pain did not improve significantly,but the VAS scores of nasal congestion and anosmia decreased and the UPSIT scores increased significantly(P<0.05),suggesting the improvement of nasal symptoms.After treatment,NPS,LMS and 22-item sinonasal outcomes test(SNOT-22)scores were significantly decreased(P<0.05),indicating that sinus inflammation was obviously controlled and quality of life was improved.Pulmonary ventilation function improved,FeNO decreased and asthma control test(ACT)score increased,indicating significant improvement in lower airway inflammation control and symptoms(P<0.05).The absolute value of peripheral blood eosinophils decreased significantly(P<0.05).Incidence of adverse reaction of 270 injections was 0.3%,indicating good safety.Conclusion The application of omalizumab can effectively control the upper and lower airway inflammation of AERD and improve the quality of life of patients with reliable efficacy and good safety.

关 键 词：阿司匹林加重性呼吸系统疾病 奥马珠单抗 哮喘 慢性鼻窦炎伴鼻息肉 

分 类 号：R765.41[医药卫生—耳鼻咽喉科]