嗜酸粒细胞分类伴息肉型慢性鼻-鼻窦炎的临界值观察

目的 探索以组织嗜酸粒细胞(Eos)浸润程度来分类伴鼻息肉型慢性鼻-鼻窦炎(CRSwNP)可能存在的临界值.方法 收集140例CRSwNP患者术前临床资料,术中收集鼻息肉组织评估组织Eos,术后3个月和6个月时随访.结果 将组织Eos以≤50个Eos/高倍镜视野(HPF)为临界点分组时,术前视觉模拟、鼻窦CT、鼻内镜评分,术后3个月及6个月鼻内镜评分差异有统计学意义(P<0.05);变应原皮肤试验阳性组与阴性组的组织Eos间差异无统计学意义;组织Eos与外周血Eos百分比及绝对值在置信度为0.01时呈显著相关性(ρ=0.459、0.473,P<0.01).结论 对区分嗜酸粒细胞型鼻窦炎与非嗜酸粒细胞型鼻窦炎最有意义的临界点可能在50 个Eos/HPF附近(取息肉组织,随机HPF);变应性因素可能对CRSwNP患者鼻息肉组织的Eos增多无影响或影响不大;外周血Eos可能能够成为代表组织Eos高低的一项指标.

The cutoff point of chronic nasal sinusitiswith nasal polyps classified by the tissue eosinophils

Objective To study the cutoff point of chronic nasal sinusitis with nasal polyps(CRSwNP) classified by the tissue eosinophils(Eos).Methods 140 CRSwNP patients were enrolled in this study.The data of their clinical feature were collectted before surgery.Mucosal specimens were assessed for the presence of tissue eosinophil cells.Follow up and record the data at 3 months and 6 months after surgery.Results When the tissue Eos grouped by 50/HPF, the VAS, nasal sinus CT ,endoscopic preoperative score,and the endoscopic postoperative score at 3 months and 6 months showed significant difference(P<0.05).The tissue Eos between skin prick test(SPT) positive group and SPT negative group showed no significant difference.The tissues Eos was sighificantly correlated with the peripheral Eos(ρ=0.459,0.473,P<0.01).Conclusion The most meaningful cutoff point may be 50 Eos/HPF nearby to distinguish ECRS and non-ECRS(taken nasal polyps,by random HPF).Allergic factors may have no effect or little effect on the increase in Eos of nasal polyps in patients with CRSwNP;peripheral blood Eos may be an indicator of the level of Eos in tissues.