变应性因素与慢性鼻-鼻窦炎伴/不伴鼻息肉的相关性

摘要

目的 分析变应性因素在慢性鼻-鼻窦炎伴鼻息肉(CRSwNP)和不伴鼻息肉(CRSsNP)患者中的分布情况,并探讨其对CRS严重程度的影响.方法 回顾性分析2014年1月至2016年12月海南省人民医院耳鼻咽喉头颈外科收治的254例CRS手术患者,其中CRSsNP 132例,CRSwNP 122例,比较两组患者在sIgE阳性率及变应性鼻炎、哮喘的患病率的差异.根据是否存在变应性因素,进一步将患者分为sIgE阳性组和IgE阴性组,对鼻窦CT Lund-MacKay评分进行比较.结果 CRSsNP和CRSwNP两组患者在sIgE阳性率(44.70％vs 39.34％)、变应性鼻炎和哮喘的患病率(31.06％vs 36.89％;9.09％vs 15.57％)以及外周血嗜酸性粒细胞计数[(0.29±0.21)×109/L vs(0.35±0.32)×109/L)]方面比较差异均无统计学意义(P>0.05);sIgE阳性和sIgE阴性患者鼻窦CT评分在CRSsNP组[(7.37±3.13)分vs(6.71±3.52)分]和CRSwNP组[(11.93±6.29)分vs(11.20±6.03)分]比较差异均无统计学意义(P>0.05);CRSsNP和CRSwNP患者CT评分与外周血中性粒细胞数呈正相关(r=0.415,P<0.05;r=0.383,P<0.01).结论 变应性因素的分布在CRSsNP和CRSwNP之间无显著差异,其可能参与CRS的发病,却不影响疾病的严重程度.%Objective To explore the correlation between allergy to chronic rhinosinusitis (CRS) with or with-out nasal polyps, and to discuss the effect of allergy on the severity of sinus inflammation. Methods In this retrospec-tive research, 254 CRS cases who admitted to Department of Otorhinolaryngology-Head and Neck Surgery of Hainan General Hospital from January 2104 to December 2016 were selected: 132 suffered from CRS without nasal polyps (CRSsNP), 122 had CRS with nasal polyps (CRSwNP). The positive rate of sIgE and the prevalence of allergic rhinitis (AR) and asthma of the two groups were compared. According to the presence or absence of allergic factors, the patients were further divided into sIgE positive group and IgE negative group, and Lund-Mackay CT system scoring were com-pared. Results There was no significant difference between CRSsNP and CRSwNP in the positive rate of sIgE assay (44.70％vs 39.34％), prevalence of AR (31.06％vs 36.89％) and asthma (9.09％vs 15.57％), and circulating eosinophils (0.29±0.21)×109/L vs (0.35±0.32)×109/L (P=0.388, 0.327, 0.162, 0.076, respectively). SIgE positive and sIgE negative pa-tients in CRSsNP and CRSwNP had similar LundMacKay CT scores, (7.37±3.13) vs (6.71±3.52), P=0.263;(11.93±6.29) vs (11.20 ± 6.03), P=0.522. Interestingly, CT scores were correlated positively with blood neutrophil count (r=0.415, P<0.05;r=0.383, P<0.01). Conclusion Allergy might play equally important role in both CRS with NP and without NP. Our findings suggested that allergy might play an important role in the occurrence of CRS, but have a modest effect on radiologic severity of the CRS.