嗜酸性粒细胞性和非嗜酸性粒细胞性的慢性鼻窦炎鼻息肉部分临床对比研究

【目的】探讨嗜酸性粒细胞性和非嗜酸性粒细胞性伴鼻息肉慢性鼻鼻窦炎的临床特点。【方法】回顾性分析76例慢性鼻窦炎鼻息肉患者,根据外周血嗜酸性粒细胞增高及鼻分泌物涂片嗜酸性粒细胞含量,将其分为嗜酸性粒细胞组和非嗜酸性粒细胞组,比较两组症状VAS评分、鼻息肉主观评分、鼻窦CT Lund-MacKay评分、嗅觉功能、鼻阻力、血清总IgE等指标间的差异。【结果】76例患者中,非嗜酸性组45例,嗜酸性组31例。非嗜酸性粒细胞组鼻息肉在临床病例中占59.2%;两组间症状VAS评分和鼻息肉主观评分无显著性差异（t=0.87,P=0.40;t=0.58,P=0.64）。鼻窦CT的Lund-MacKay评分,嗜酸性组的筛窦病变程度较非嗜酸性组严重,存在显著性差异（t=2.11,P=0.03）,而其余各鼻窦及OMC区均无显著性差异。两组间嗅觉功能以及双侧鼻腔总阻力亦无显著性差异（t=0.15,P=0.88;t=0.57,P=0.61）。【结论】嗜酸性粒细胞升高在慢性鼻窦炎鼻息肉的发病中不起主导作用,对临床症状、鼻息肉大小、嗅觉功能和鼻阻力等方面没有显著影响,但可能与筛窦的病变程度存在一定相关性。

Eosinophilic and non-eosinophilic chronic rhinosinusitis and nasal polyps clinical comparative study

【Objective】To study the eosinophilic and non-eosinophilic chronic nasal sinusitis with nasal polyps＇ clinical characteristics.【Methods】Retrospective analysis of 76 cases with chronic sinusitis and nasal polyps,according to peripheral blood eosinophilia and nasal secretion smear eosinophil content,which can be divided into eosinophilic and non-eosinophilic group,compared two groups of symptoms of VAS score,nasal polyps,nasal sinus CT subjective scoring the score of Lund-MacKay,olfactory function,nasal resistance,total serum IgE index difference.【Results】in the 76 patients,non eosinophilic group 45 cases,31 cases of eosinophilic group.Non eosinophilic group of nasal polyps in clinical cases accounted for 59.2%;VAS score between two groups of symptoms of nasal polyps and subjective scores showed no significant difference（t = 0.87,P = 0.40;t = 0.58,P = 0.64）.Sinus CT Lund-MacKay score,eosinophilic group ethmoid lesion degree is a severe eosinophilic group,there was significant difference（t = 2.11,P = 0.03）,while the rest of the paranasal sinuses and OMC showed no significant difference.Two groups of olfactory function and bilateral nasal resistance and no significant difference（t = 0.15,P = 0.88;t = 0.57,P = 0.61）.【Conclusions】Eosinophils rise in the pathogenesis of chronic sinusitis and nasal polyp did not leading role,the clinical symptoms,nasal polyp size,olfactory function and nasal resistance,etc,no significant effect,but may be and ethmoid sinus lesions has certain degree of correlation.