[Effects of different dosages of oral glucocorticoids on short-term recovery and recurrence of eosinophilic chronic rhinosinusitis with nasal polyps].

Abstract

Objective:To analyze the effects of different dosages of oral glucocorticoids on short-term recovery and recurrence in patients with eosinophilic chronic rhinosinusitis with nasal polyps（ECRSwNP）. Methods:150 patients with ECRSwNP who underwent functional endoscopic sinus surgery for the first time after the failure of maximum drug therapy were recruited. They were randomly divided into group A, B and C, and their baseline demographic and clinical characteristics were recorded. Group A, B and C were treated with 30 mg, 45 mg and 60 mg oral prednisone tablets once a day separately for 14 consecutive days. Patients in the three groups were regularly followed up at 1, 3 and 6 months after surgery. Visual analogue score （VAS）, 20 item Sino-Nasal Outcome Test （SNOT-20） and Lund-Kennedy endoscopic score （LKS） were completed. The subjective and objective scores and the recurrence of polys 6 months after surgery were compared, and the related factors were analyzed. Results:There were 49 patients in group A, 44 patients in group B and 45 patients in group C in this study. The age of the three groups was significant difference （0.021）, but no significant difference was found in other demographic characteristics such as sex, smoking and so on, and the baseline subjective and objective scores of diseases between three groups（P>0.05）. The VAS, SNOT-20 and LKS score in group B and C was significantly lower than that in group A at 1 month after surgery, but there was no significant difference between group B and C. The LKS score in group C was significantly lower than that in group A and B at 3 months after surgery, but there was no significant difference between group A and group B. There was no significant difference in subjective and objective scores as well as disease recurrence among three groups at 6 months after surgery. However, the recurrence rate of patients with asthma was significantly higher than that in patients without asthma in three groups （62.50% vs 4.88%, 55.56% vs 5.71%, 66.67% vs 7.69% respectively）. Conclusion:Postoperative oral glucocorticoids therapy at moderate or higher dosage can improve the subjective and objective scores of ECRSwNP patients 1 month after surgery, but increasing the dosage did not increase its benefit. Different dosages of oral glucocorticoids had no significant effect on the subjective scores at 3 months, the subjective and objective scores as well as the recurrence of polyps at 6 months after surgery. Asthma is an important factor affecting the recurrence of polyps at 6 months after surgery in patients with ECRSwNP.