慢性鼻窦炎发病因素相关研究进展

Research Progress of Pathogenic Factors of Chronic Sinusitis

摘要: 慢性鼻窦炎(chronic rhinosinusitis, CRS)被定义为指持续12周以上的鼻腔及鼻窦黏膜炎性疾病。患者常常表现为鼻塞、黏脓性鼻涕、头面部胀痛、嗅觉减退或丧失等症状。基于全球广泛采用且较为直观的医学分类方法，慢性鼻窦炎可分为无鼻息肉伴随的慢性鼻窦炎(简称CRSsNP)、有鼻息肉伴随的慢性鼻窦炎(简称CRSwNP)。当前，CRS的确切病因和病理过程仍处于未知状态，然而可能与以下几种情况相关：鼻腔解剖变异(例如鼻中隔偏移、窦口–鼻道复合体发育异常、钩突位置异常等)、微生物侵袭、免疫功能异常、纤毛运动障碍、胃食管返流、囊性纤维化、遗传要素以及环境刺激和过敏反应等。CRS可单侧或双侧出现，双侧情形较为普遍。此症不仅损害患者的生理健康，而且因其持续的周期性发作，对患者的心理层面亦产生负面影响。鉴于此，深入探究慢性阻塞性呼吸道疾病(CRS)的诱因与病理机制至关重要。针对这些关键点实施全面性的临床疗法，能够有效提升治疗效果并降低病情反复的风险。该篇论文着重梳理分析了现阶段学术研究中揭示的慢性鼻窦炎的诱发要素，并跟踪报道了该领域现状的最新研究成果。

Abstract: Chronic rhinosinusitis (CRS) is characterized as an inflammatory disorder affecting the nasal cavity and paranasal sinuses, with a duration exceeding 12 weeks. Patients may present with nasal congestion, mucopurulent nasal discharge, head and face swelling pain, reduced or loss of smell and other symptoms. According to the widely adopted and more intuitive medical classification worldwide, chronic rhinosinusitis can be classified into chronic rhino sinusitis without nasal polyps (abbreviated as CRSsNP) and chronic rhino sinusitis with nasal polyps (abbreviated as CRSwNP). At present, the specific pathogenic factors and pathogenesis of CRS have not been clarified, but it may be related to the following factors: abnormal nasal anatomy (such as deviated nasal septum, abnormal development of the sinusostomal-nasal tract complex, uncinate process displacement, etc.), microbial infestation, immune dysfunction, ciliary dysfunction, gastroesophageal reflux, cystic fibrosis, genetic and environmental factors, and allergic reactions. CRS can occur either unilaterally or bilaterally, with bilateral occurrence being more common. This disease not only affects the physical health of patients, but also causes adverse effects on the psychological state of patients due to its long-term recurrence. Therefore, it is important to investigate the causes and pathogenesis of CRS, and comprehensive treatment for these links in clinical practice is helpful to improve curative effects and reduce risk of recurrence. This paper focuses on the triggering factors of chronic rhinosinusitis as revealed in the current academic research and follows up the latest research findings in this field.