Abstract
Chronic rhinosinusitis (CRS) is a clinical syndrome including several clinical phenotypes and endotypes with differences in pathophysiology. CRS with nasal polyposis (NP) is the most severe CRS phenotype associated with a significant influence on the patients’ quality of life. Peculiarities of the endotype of CRS with NP justify the use of aminocapronic acid (ACA) not only for preoperative preparation, but also as a means of pharmacotherapy. Aim: assessment of the dynamics of the life quality of patients with CRS with NP, with the addit ional prescription of aminocapronic acid in comparison with standard therapy according to clinical recommendations. Material and methods: The study included 120 outpatients, divided into two groups: the main (n=60) and control (n= 60) ones. Patients were prescribed basic treatment (irrigation therapy with saline solutions and mometasone furoate), and in the main group additionally aminocapronic acid (ACA). The evaluation of the treatment effectiveness was based on the analysis of the dynamics of clinical symptoms: decreased sense of smell, sleep disturbances, reduced work capacity, as well as the total number of points according to SNOT-22 at V2 (5±1), V3 (10±1), V4 (20±1) and V5 (30±1) compared to V0. Indications for surgical treatment were determined at V3. Results: The use of aminocapronic acid in CRS with NP promotes significant decrease of the severity of the main clinical symptoms and improvement of the quality of patients’ life in the main group at V2 and V3 compared to the control group. This provided a statistically significant increase at 25% in the number of patients who were performed conservative treatment further (p<0.05). After the removal of the operated patients, the groups statistically did not differ significantly in terms of the dynamics of life quality indices at V4 and V5 (p>0.05). Differences in the results of treatment are attributed to the clinical effects of ACA, since the group characteristics of the patients were comparable. Conclusions: the use of ACA in addition to the basic therapy for patients with CRS with NP, contributes to a reliable improvement of life quality indices compared to patients of the control group; reliable positive dynamics of life quality allows a 25% increase in the patients who continue to be performed pharmacotherapy.
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