侵袭型真菌性鼻-鼻窦炎发病高危因素分析

摘要

Objective To investigate invasive fungal rhino-sinusitis (IFRS) associated risk factors. Methods Selected 32 cases of IFRS from May 2005 to May 2015 in our hospital (invasive group), simultaneously selected 124 cases of non-invasive fungal rhino-sinusitis(NIFRS) patients (non-invasive group), collected the clinical data of two groups of patients, used non-conditional Logistic regression to analyze IFRS related risk factors. Results Single factor analysis showed that there were statistically significant difference between two group in age, history of diabetes, and long-term use of hormones or antibiotics smell drops, the tears with blood, nasal neoplasm, nasal septum deviation, calcified plaque(P<0.05) .Multivariate logistic regression analysis showed that age (P=0.025), history of diabetes (P=0.003), nasal neoplasm (P=0.006), nasal septum deviation (P=0.022), calcified plaque (P=0.002) and bone destruction (P=0.004) were the independent risk factors for IFRS. Conclusion Age, history of diabetes, nasal neoplasm, nasal septum deviation, calcified plaque and bone destruction were the independent risk factors for IFRS. To improve the level of disease detection, screening could be the focus for patients with the above risk factors.%目的 探讨侵袭型真菌性鼻-鼻窦炎发病相关的高危因素.方法 选取2005年5月~2016年5月我院收治的32例侵袭型真菌性鼻-鼻窦炎患者为侵袭组,同时选取124例非侵袭型真菌性鼻-鼻窦炎患者为非侵袭组,收集两组患者的临床资料,采用多因素Logistic回归分析侵袭型真菌性鼻-鼻窦炎的高危因素.结果 单因素分析结果表明两组在年龄、糖尿病史、长期激素或抗生素使用、嗅觉下降、涕中带血、鼻腔新生物、鼻中隔偏曲、钙化斑、骨质破坏等方面,差异具有显著性意义(P<0.05).多因素Logistic回归分析结果表明年龄(P=0.023)、糖尿病(P=0.003)、鼻腔新生物(P=0.006)、鼻中隔偏曲(P=0.022)、钙化斑(P=0.002)、骨质破坏(P=0.004)为侵袭型真菌性鼻-鼻窦炎发病的独立危险因素.结论 高龄、合并糖尿病、鼻腔新生物、鼻中隔偏曲、钙化斑和骨质破坏是侵袭型真菌性鼻-鼻窦炎的高危因素,对于存在上述高危因素的患者应予以重点筛查,以提高疾病检出水平.