检索历史 清除

目的:采用孟德尔随机化（two-sample Mendelian randomization，MR）方法，揭示哮喘和变应性鼻炎（AR）与慢性鼻窦炎（CRS）之间的因果关系，为CRS的发病机制和临床诊疗提供依据。方法:选用哮喘、AR的遗传变异作为工具变量，从综合流行病学部门（Integrative Epidemiology Unit，IEU）公开数据库中获取相关遗传数据，哮喘和AR的病例数分别为14 283和18 934，其相应的正常对照组病例数分别为98 300和64 595；慢性鼻窦炎伴鼻息肉（CRSwNP）和慢性鼻窦炎不伴鼻息肉（CRSsNP）的病例数分别为3 236和8 524，正常对照组病例数分别为167 849和167 849。使用逆方差加权法（inverse variance weighting method，IVW）、MR-Egger法和加权中位数法（weighted median，WM）以及Cochran′s Q检验对上述遗传数据进行分析。结果:IVW分析结果显示，哮喘可同时增加CRSwNP和CRSsNP的患病风险（ OR=482.8，95% CI：57.18~4 077.78， P<0.001； OR=25.73，95% CI：9.79~67.56， P<0.001）；AR可增加CRSsNP的患病风险（ OR=5.40，95% CI：1.68~17.26， P=0.004），但与CRSwNP患病风险增加无显著关联（ OR=7.38，95% CI：0.80~67.73， P=0.077）。然而，CRSwNP和CRSsNP均不增加哮喘和AR的风险。 结论:根据MR方法分析发现，哮喘是CRSwNP和CRSsNP的患病危险因素，而AR是CRSsNP的危险因素。

Objective:To explore the causal relationship between asthma, allergic rhinitis (AR), and chronic sinusitis (CRS), using two sample Mendelian randomization (MR) analysis, thereby providing foundational evidences for the pathogenesis and treatment of CRS.Methods:The genetic variations in AR and asthma were used as instrumental variables, with genetic data from the Integrated Epidemiology Unit (IEU) Open database. A total of 14 283 asthma and 18 934 AR cases were included, with 98 300 and 64 595 corresponding normal control cases, respectively. For CRS, there were 3 236 CRSwNP and 8 524 CRSsNP, respectively, with 167 849 and 167 849 corresponding normal control cases, respectively. The genetic data were analyzed using the inverse variance weighting method (IVW), MR Egger method, weighted median method, and Cochran′s Q-test.Results:The IVW analysis showed that asthma increased the risk of both CRSwNP ( OR=482.8, 95% CI: 57.18-4 077.78, P<0.001) and CRSsNP ( OR=25.73, 95% CI: 9.79-67.56, P<0.001); AR significantly increased the risk of CRSsNP ( OR=5.40, 95% CI: 1.68-17.26, P=0.004), but not CRSwNP ( OR=7.38, 95% CI: 0.80-67.73, P=0.077). Conversely, neither CRSwNP nor CRSsNP increased the risk of asthma or AR. Conclusion:According to Mendelian genetic laws, asthma is a risk factor for CRSwNP and CRSsNP, while AR is a risk factor for CRSsNP.