变应性真菌性鼻-鼻窦炎的综合诊断

摘要

目的 评价变应性真菌性鼻-鼻窦炎诊断方法的临床应用.方法 总结18例变应性真菌性鼻-鼻窦炎病例,分析其临床特点、CT和MRI影像学特征,通过皮肤点刺试验、血清学检查结果、鼻窦分泌物压片/涂片和培养确定致病真菌的种类,通过病理学方法观察黏膜组织和变应性黏蛋白的特点.结果 18例患者中,男性11例,女性7例,患者年龄17~66岁,通过皮肤点刺试验、血清特异性IgE检测结合真菌压片/涂片和培养检查,明确致病真菌主要为曲霉菌,黏蛋白病理学检查可见嗜酸性粒细胞和Charcot-Leyden晶体.结论 变应性真菌性鼻-鼻窦炎的诊断需要综合临床表现、影像学特点、皮肤点刺试验和血清学检查、真菌病原学以及病理学检查.%Objective To evaluate the clinical application of different diagnostic methods in the diagnosis of allergic fungal rhinosinusitis. Methods Eighteen cases of allergic fungal rhinosinusitis were enrolled in the present study, clinical characteristics, CT and MRI images, skin prick tests (SPTs) , serum specific IgE, smear and culture of mucin and pathological diagnosis were used as diagnostic methods. Results The ratio of male to female was 11/7, and the age range was 17—66 years. The CT and MRI of sinuses showed typical characteristics. The main fungus was aspergillus diagnosed by SPTs, serum specific IgE, smear and culture of mucin in sinuses. Eosinophils and Char cot-Ley den crystals could be found in mucin. Conclusion The diagnosis of allergic fungal rhinosinusitis depends on combination of clinical characteristics, CT and MRI images, SPTs, serum specific IgE, smear and culture of mucin and pathological diagnosis.