Povezanost laringofaringealnog refluksa i kroničnog rinosinuitisa

Anzić, Srđan, Ante (2011) Povezanost laringofaringealnog refluksa i kroničnog rinosinuitisa. PhD thesis, Sveučilište u Zagrebu.

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Abstract

Chronic paranasal sinus inflammation is still in the realm of scientific interest, as its etiology and connection with other respiratory system conditions has not yet been sufficiently clarified. The hypothesis of this study is based on the correlation between laryngopharyngeal reflux (LPR) and chronic paranasal sinus inflammation. The aim of this study was to ascertain whether treating the laryngopharyngeal reflux with proton pump inhibitors influences the quality of the chronic rhinosinusitis treatment. The research was carried out as a double blind test comprising of 60 participants, 28 women and 32 men with the LPR symptoms and diagnosed chronic paranasal sinus inflammation. To confirm both diagnoses, all the participants underwent testing, which included the reflux symptom index (RSI), reflux finding score (RFS), eosinophil cationic protein analysis of the nasal lavage fluid, and the 24-hour pH-evaluation using an esophageal sensor indicating the number and the size of the reflux episodes incidence. The participants were then divided into two groups. For the next 60 days, the first group was given proton pump inhibitors (Omeprazole) in 20 mg doses, while those in the control-group were given placebo doses. The initial testing was repeated after completion of the therapy. 85 The results support the hypothesis claiming the improvement of patient condition after proton pump inhibitor treatment (Omeprazole) in 20 mg doses a day during two months’ period in chronic rhinosinusitis. The study results contribute to our understanding of the connection between the chronic rhinosinusitis and the laryngopharyngeal reflux, as well as to the change of the attitudes towards the proton pump inhibitors in treating the chronic rhinosinusitis.

Abstract in Croatian

Kronični rinosinuitis (KRS) je bolest još uvijek nedovoljno razjašnjene etiologije i nerazjašnjene povezanosti s nekim drugim bolestima. Hipoteza ovog istraživanja je da postoji povezanost laringofaringealnog refluksa i kroničnog rinosinuitisa te da se liječenjem laringofaringealnog refluksa inhibitorima protonske pumpe smanjuju simptomi kroničnog rinosinuitisa. Cilj istraživanja je bio istražiti povezanost simptoma LPR-a sa simptomima KRS-a, prije i poslije terapije, istražiti povezanost intenziteta simptoma KRS-a s rezultatima pH-metrije i utvrditi učinkovitost terapije LPR-a inhibitorima protonske pumpe (IPP-om) u poboljšanju lokalnog nalaza i subjektivnih simptoma kako laringofaringitisa tako i kroničnog rinosinuitisa. Istraživanje je provedeno kao dvostruki slijepi pokus na uzorku od 60 ispitanika, 28 žena i 32 muškarca, sa simptomima LPR-a i dokazanim KRS-om. Svim ispitanicima prije i nakon završetka studije ocjenjivani su simptomi KRS-a i LPR-a (reflux simptom index (RSI) i reflux finding score (RFS)), ocjenjivan je endoskopski nalaz sluznice nosa, histopatološki analizirana sluznica nosa, rañena analiza eozinofil kationskog proteina (ECP) u ispirku nosne šupljine, te 24-satna pH-metrija. Bolesnici su podijeljeni u dvije skupine, prva je tijekom sljedećih šezdeset dana uzimala inhibitor protonske pumpe (omeprazol) u dozi 20 mg, dok je kontrolna skupina uzimala placebo. Terapija inhibitorima protonske pumpe (omeprazol) u dozi 1x20 mg u trajanju od dva mjeseca statistički značajno pridonosi poboljšanju simptoma kroničnog rinosinuitisa i endoskopskog nalaza u odnosu na prijeterapijski nalaz. 83 Dobiveni rezultati istraživanja govore u prilog hipotezi povezanosti KRS-a i LPR-a s obzirom na poboljšanja stanja KRS-a nakon liječenja LPR-a inhibitorom protonske pumpe.

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