血清sIgE、总IgE、EOS与慢性鼻-鼻窦炎伴鼻息肉发生的相关性分析

目的：探讨血清sIgE、总IgE浓度梯度、嗜酸粒细胞（EOS）与慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）发生的危险因素以及临床指标的筛选。方法：将152例慢性鼻-鼻窦炎患者分为慢性鼻-鼻窦炎不伴鼻息肉（CRSs—NP）组和CRSwNP组，行体外20种过敏原筛查，测定血清sIgE、总IgE、EOS百分比。结果：①CRSsNP患者血清总IgE浓度主要集中在1级，而CRSwNP患者血清总IgE浓度主要集中在2、3级（Z=0．906，P〉0．05）。分别比较两组患者血清sIgE分级．差异无统计学意义（P〉0．05）。②CRSwNP患者EOS百分比明显高于CRSsNP患者（F=4．337，P=0．039；t=3．315，P〈0．01）。且CRSwNP患者E0s百分比95％可信区间为3．90％～5．26％，5％TM值为4．3％，高于CRSsNP组及正常值。CRSwNP组患者EOS百分比，按sIgE值分梯度（分级）后，CRSwNP各组（级）之间比较差异均无统计学意义（P〉0．05）。③CRSwNP患者变应原多为混合型变应原，并且随着变应原浓度梯度的升高，混合型变应原过敏的CRSwNP组患者比例高于CRSsNP患者（χ2=8．595，P〈20．05）。结论：CRSwNP的发牛与EOS、混合变应原的存存有关。且当EOS百分比在3．90％～5．26％范围内CRSwNP更易发生。而血清总IgE、sIgE浓度不能单独作为CRswNP的发生因素。利用过敏原筛查结果结合临床症状，能更早地了解并远离过敏原，利于慢性鼻鼻窦炎围手术期治疗方案的制定。

Association analysis of sIgE,IgE,EOS and the occurrence of chronic rhinosinusitis with nasal polyps

Objective：To discuss the relation between total IgE,special IgE and acidophilicgranulocyte of serum in blood and the occurrence of nasal polyps（NP） of chornic rbinosinusitis（CRS） patients, and then to get the best clinic index. Method：One hundred and fifty two cases of CRS patients were divided into two groups（CRSsNP, CRSwNP）. Allergen in vilro were screened, and then. the acidophilicgranuloeyte percentage and the total IgE of serum in blood were determined. Result： ①The IgE concentration of CRSsNP was mainly at one level while the IgE concentration of CRSwNP was mainly at two or three levels（Z=0. 906, P〉0.05）. There was no significant difference of sIgE serum between the two groups. ②The EOS percentage of CRSwNP was distinctly higher than that of CRSsNP（F=4. 337,P=0. 039;t=3. 315,P〈0.01）. The 95%confidential interval（CI）of EOS of CRSwNP was 3.90%-5.26%, 5% TM value was 4.3%, which were higher than the concentration of CRSsNP and normal value. There was no significant difference between different groups（classes） if the CRSwNP group were classified by sIgE concentration（P〉0.05）. ③CRSwNP patients were mainly mixed-type allergen allergy and the proportion of patients with this mixed-type allergen would increase in accordance with the increasing of allergen concentration gradient（χ2=8. 595, P〈 0. 05）. Conclusion： The occurrence of CRSwNP is related to the increase of EOS and mixed allergens. When the concentration of EOS range from 3.90% to 5.26%, CRSwNP is more likely to occur. The concentration of total IgE and slgE are not the risk factors singly. Allergen screening result combined with the clinical symptoms can help to get knowledge of and keep away from allergen, and also is beneficial to make treatment plan of perioperative period of CRS.