慢性鼻-鼻窦炎伴鼻息肉复发的相关影响因素分析

doi:10.6040/j.issn.1673-3770.0.2016.302

摘要/Abstract

摘要： 目的探讨慢性鼻-鼻窦炎伴鼻息肉(CRSwNP)复发的相关影响因素。方法选取2011年2月至2014年3月就诊的CRSwNP患者206例,收集临床资料,鼻息肉组织病理学检查,所有患者手术治疗后进行随访,记录患者术后鼻息肉复发情况。结果 CRSwNP患者随访中,115例(55.8%)患者出现复发,91例(44.2%)患者未出现复发,复发组患者合并哮喘比例、外周血Eos比例、流涕评分、头/面疼痛评分、嗅觉损伤、Lund-Mackay评分和组织嗜酸性粒细胞(Eos)比例均高于未复发组,而外周血中性粒细胞(Neu)比例、组织Neu比例、组织淋巴细胞比例和组织浆细胞比例均低于未复发组,差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,组织嗜酸性粒细胞(Eos)比例是影响CRSwNP复发的独立危险因素(P<0.001);ROC曲线分析显示,组织Eos比例在预测CRSwNP复发时,曲线下面积0.948(95%CI:0.923~0.974),当组织Eos比例为18.9%时,灵敏度75.8%,特异度98.3%。结论组织Eos比例是影响CRSwNP复发的独立危险因素,当组织Eos比例为18.9%时,具有最佳的诊断价值。

关键词: 复发, 慢性鼻-鼻窦炎, 影响因素, 鼻息肉

Abstract: Objective To investigate the factors related to the recurrence of chronic rhinosinusitis with nasal polyps(CRSwNP). Methods A total of 206 patients with CRSwNP hospitalized in our department From February 2011 to March 2014 were enrolled in this study. The clinical data were collected. The histopathological examinations of nasal polyps were taken. All the patients were followed up after the operation. Results In the following up, 115(55.8%)patients with CRSwNP were recurred and 91(44.2%)were not. The proportion of asthmatic, the proportion of Eos in peripheral blood, runny nose score, head/face pain score, olfactory damage, Lund-Mackay score and the proportion of eosinophil(Eos)in tissues in the recurrence group were higher than those in the non-recurrence group, while the proportion of neutrophils(Neu)in peripheral blood, the proportion of Neu in tissues, the proportion of lymphocytes in tissues and the proportion of plasma cells in the tissues in the recurrence group were lower than those in the non-recurrence group(P<0.05). Multivariate Logistic regression analysis showed that the proportion of eosinophils(Eos)in tissues was an independent risk factor for recurrence of CRSwNP(P<0.001). The ROC curve showed that the proportion of Eos in tissues in predicting the recurrences of CRSwNP, the area under the curve was 0.948(95% CI: 0.923-0.974). When the proportion of Eos was 18.9%, the sensitivity was 75.8% and the specificity was 98.3%. Conclusion The proportion of Eos in tissues was independent risk factor for recurrence of CRSwNP, and when the proportion of Eos in tissues was 18.9%, it had the best diagnostic value.

Key words: Nasal polyps, Chronic rhinosinusitis, Recurrence, Influencing factors

中图分类号:

R765.4

伦杰,张亚楠. 慢性鼻-鼻窦炎伴鼻息肉复发的相关影响因素分析[J]. 山东大学耳鼻喉眼学报, 2017, 31(3): 80-83.

LUN Jie, ZHANG Ya′nan. Analysis on the factors related to the recurrence of chronic rhinosinusitis with nasal polyps.[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(3): 80-83.

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