慢性鼻窦炎鼻息肉与变应性因素相关性的探讨

目的 探讨变应性因素在慢性鼻窦炎鼻息肉发病中的作用。方法回顾性分析1882例慢性鼻窦炎鼻息肉患者术前鼻腔分泌物涂片嗜酸粒细胞及变应原皮肤试验检查结果，并将其变应性症状和体征出现的比例与临床分型分期加以比较。结果①1882例慢性鼻窦炎鼻息肉患者中60．4％(1137例)的患者伴有不同程度的变应性症状和体征，25．3％(477例)的患者合并变应性鼻炎，2．1％(39例)的患者合并支气管哮喘；②在Ⅰ型(708例)和Ⅱ型(823例)各分期的患者中，合并变应性鼻炎及支气管哮喘的发生率和嗜酸粒细胞、皮肤变应原试验阳性率以及变应性鼻炎临床症状出现的百分率分别由低到高出现，Ⅱ型3期各项比例最高；③42．2％(795例)的患者变应原皮肤试验阳性，其中94．3％对常年性变应原呈阳性反应；④26．3％(495例)的患者伴有变应性鼻炎的临床症状，其中99．8％(494／495例)为常年性发作；⑤有前期手术史的病例占38．9％(732例)，其中合并变应性鼻炎者占有前期手术史例数的38．3％(280例)，占合并变应性鼻炎患者的58．7％(477例)。结论变应性因素特别是常年性变应性鼻炎与慢性鼻窦炎鼻息肉的病变程度和病变范围有关。同时变应性鼻炎也促进了疾病的复发。

Relationship between allergic factors and chronic sinusitis with or without nasal polyps

OBJECTIVE: To explore the effects of allergic factors in chronic sinusitis and nasal polyps. METHOD: Eosinophil in nasal secretions and allergen skin test of 1882 patients with chronic sinusitis and nasal polyps were examined before endoscopic sinus surgery. The occurrence ratios of allergic symptoms and syndromes were analyzed and compared with clinical stages of chronic sinusitis and nasal polyps. RESULTS: (1) Allergic symptoms (or syndromes) were presented in 60.4% (1137 cases) of patients in different degrees, 25.3% (477 cases) patients suffered from allergic rhinitis, 2.1% (39 cases) patients had asthma; (2) The morbidities of allergic rhinitis and asthma, the positive rates of eosinophil and allergen skin test, the occurrence rates of allergic symptoms were rising with the clinical stages in type I and type II, especially in type II stage 3; (3) There were 42.2% (795 cases) positive patients in allergen skin test, among them, 94% were sensitive to perennial allergens; (4) Allergic symptoms appeared in 26.3% (495 cases) patients, among them, 99.8% attacked perennially; (5) Of all patients, there were 38.9% (732 cases) had been operated cases before, among them 38.3% (280 cases) with allergy rhinitis. In chronic sinusitis with allergy rhinitis patients, 58.7% (477 cases) were suffered from operation. CONCLUSIONS: Allergic factors,especially perennial allergic rhinitis, are relative to clinical stages of chronic sinusitis and nasal polyps. Allergic rhinitis is an important factors in recurrence.