Diana Chernikova, Richard Stiehm, Dennys Estevez, Charles H Song
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Using 70% as the threshold for adequate pneumococcal antibody (PA) response, patients were classified as: Group A (adequate pre-pPA), Group B (inadequate pre-pPA, adequate post-pPA), Group C (inadequate pre-pPA, inadequate post-pPA, SAD). Using 50% as the threshold, patients were similarly classified as: Group A', B' and C'.</p><p><strong>Results: </strong>The recurrence rate of sinusitis during the next one year in Group A (pre-pPA ≥70%) was significantly less than that of Group A' (pre-pPA ≥50%) (10% vs. 34%, P = .03). Group A had lower incidence of sinusitis than Group B (pre-pPA < 70%, post-pPA ≥70%) (10% vs. 34%, P = .025). Among Group B' patients, the recurrence rate of sinusitis was significantly less among those with post-pPA of ≥70% than those with 50%-69% (28% vs. 69%, P < .01).</p><p><strong>Conclusion: </strong>Employment of a 70% pPA threshold for SAD in comparison to a 50% threshold would decrease the incidence of sinusitis in the next one year by vaccinating patients in 51-69% pPA range. 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Using 70% as the threshold for adequate pneumococcal antibody (PA) response, patients were classified as: Group A (adequate pre-pPA), Group B (inadequate pre-pPA, adequate post-pPA), Group C (inadequate pre-pPA, inadequate post-pPA, SAD). Using 50% as the threshold, patients were similarly classified as: Group A', B' and C'.</p><p><strong>Results: </strong>The recurrence rate of sinusitis during the next one year in Group A (pre-pPA ≥70%) was significantly less than that of Group A' (pre-pPA ≥50%) (10% vs. 34%, P = .03). Group A had lower incidence of sinusitis than Group B (pre-pPA < 70%, post-pPA ≥70%) (10% vs. 34%, P = .025). 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引用次数: 2
摘要
背景:特异性抗体缺乏症(SAD)与慢性鼻窦炎(CRS)高度相关,定义为接种疫苗后保护性肺炎球菌抗体血清型(≥1.3 ug/mL)的百分比低于总检测血清型(ppa后)。目的:方法:对203例6 ~ 70岁CRS患者进行回顾性分类,按接种前pPA (pre-pPA)和接种后pPA两种不同标准进行分类。以70%作为肺炎球菌抗体(PA)充分反应的阈值,将患者分为:A组(ppa前充分),B组(ppa前充分,ppa后充分),C组(ppa前充分,ppa后充分,SAD)。以50%为阈值,将患者相似地分为:A', B'和C'组。结果:A组(pre-pPA≥70%)1年内鼻窦炎复发率明显低于A组(pre-pPA≥50%)(10% vs. 34%, P = 0.03)。结论:在51-69%的pPA范围内接种疫苗,使用70% pPA阈值与50%阈值相比,SAD的鼻窦炎发生率低于B组。预先存在的PAs (A组)比疫苗获得性抗体(B组)对鼻窦炎的保护作用更高。
Comparison of Two Different Criteria for Specific Antibody Deficiency in Patients With Chronic and Recurrent Rhinosinusitis.
Background: Specific antibody deficiency (SAD) is highly associated with chronic rhinosinusitis (CRS) and is defined by inadequate post-vaccination percentage of protective (≥1.3 ug/mL) pneumococcal antibody serotypes divided by total tested serotypes (post-pPA).
Objective: Although < 70% post-pPA has been used commonly as the criterion for SAD, we sought to evaluate the clinical outcome of a different definition of SAD.
Methods: 203 patients aged 6 to 70 years with CRS were classified, retrospectively by pre-vaccination pPA (pre-pPA) and post-pPA by two different criteria. Using 70% as the threshold for adequate pneumococcal antibody (PA) response, patients were classified as: Group A (adequate pre-pPA), Group B (inadequate pre-pPA, adequate post-pPA), Group C (inadequate pre-pPA, inadequate post-pPA, SAD). Using 50% as the threshold, patients were similarly classified as: Group A', B' and C'.
Results: The recurrence rate of sinusitis during the next one year in Group A (pre-pPA ≥70%) was significantly less than that of Group A' (pre-pPA ≥50%) (10% vs. 34%, P = .03). Group A had lower incidence of sinusitis than Group B (pre-pPA < 70%, post-pPA ≥70%) (10% vs. 34%, P = .025). Among Group B' patients, the recurrence rate of sinusitis was significantly less among those with post-pPA of ≥70% than those with 50%-69% (28% vs. 69%, P < .01).
Conclusion: Employment of a 70% pPA threshold for SAD in comparison to a 50% threshold would decrease the incidence of sinusitis in the next one year by vaccinating patients in 51-69% pPA range. Pre-existing PAs (Group A) yielded a higher protection against sinusitis than vaccine-acquired antibodies (Group B).