山东大学耳鼻喉眼学报 ›› 2019, Vol. 33 ›› Issue (1): 99-102.doi: 10.6040/j.issn.1673-3770.0.2018.567

• 论著 • 上一篇    下一篇

不伴有下气道疾病的慢性鼻-鼻窦炎患者肺功能及相关因素分析

王亚坤1,2,张宇3,宋西成3   

  1. 1.滨州医学院, 山东 烟台 264003;
    2.烟台毓璜顶医院莱山分院耳鼻咽喉科, 山东 烟台 264003;
    3.青岛大学附属烟台毓璜顶医院耳鼻咽喉头颈外科, 山东 烟台 264000
  • 出版日期:2019-01-20 发布日期:2019-01-28
  • 作者简介:王亚坤. E-mail:wangyakun312@126.com

Analysis of pulmonary function and its influencing factors in chronic rhinosinusitis without lower airway disease

WANG Yakun1,2, ZHANG Yu3, SONG Xicheng3   

  1. Department of Otorhinolaryngology, Yantai Yuhuangding Laishan Hospital, Yantai 264003, Shandong, China;
    3. Department of Otorhinolaryngology Head and Neck Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai 264000, Shandong, China
  • Online:2019-01-20 Published:2019-01-28

摘要: 目的 探讨不伴有下气道疾病的慢性鼻-鼻窦炎伴息肉患者的肺功能及其影响因素。 方法 选取161例慢性鼻-鼻窦炎伴鼻息肉患者(CRSwNP组),26例慢性鼻-鼻窦炎不伴鼻息肉患者(CRSsNP组)和34例正常人(对照组)进行肺功能检测,比较三组肺功能的各项指标,并分析CRSwNP组肺功能和临床各参数之间的关系,这些参数包括外周血嗜酸粒细胞数、血清特异性IgE、Lund-Mackay评分、呼出一氧化氮水平和视觉模拟量表评分(VAS)。 结果 CRSwNP组患者的肺功能指标FEV1%pre低于正常组,差异有统计学意义(P=0.045);血清特异性IgE(sIgE)与VC%、FEV1%pre、FEV1/FVC呈负相关(P<0.05)。 结论 不伴下气道疾病的CRSwNP患者存在潜在的阻塞性肺功能改变;sIgE与CRSwNP的肺功能异常有关。

关键词: 慢性鼻-鼻窦炎, 鼻息肉, 肺功能, 下气道, 相关因素

Abstract: Objective To explore pulmonary function and its related influences in chronic rhinosinusitis patients with nasal polyps(CRSwNP)without lower airway disease. Methods One hundred and sixty-one patients with chronic rhinosinusitis with nasal polyps(CRSwNP), 26 patients with chronic rhinosinusitis without nasal polyps(CRSsNP), and 34 healthy people serving as a control group were enrolled in this study. We compared pulmonary function among these three groups and analyzed the association between pulmonary function and clinical parameters in patients with CRSwNP. These clinical parameters included serum eosinophil count, serum-specific allergen IgE(sIgE), Lund-Mackay scores, exhaled nitric oxide levels, and VAS scores. Results Percentages of predicted forced expiratory volume in 1 second(FEV1%pre)in the CRSwNP group were significantly lower than those in the control group(P<0.05), and sIgE was negatively correlated with vital capacity(VC), FEV1%pre, and FEV1/FVC(P<0.05). Conclusion The results suggest a potential obstructive pulmonary function change in patients with chronic rhinosinusitis. Serum-specific allergen IgE may be associated with changes in lung function in chronic rhinosinusitis.

Key words: Chronic rhinosinusitis, Nasal polyps, Pulmonary function, Lower airways, Factors

中图分类号: 

  • R765.4
[1] Fokkens WJ, Lund VJ, Mullol J, et al. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists[J]. Rhinology, 2012, 50(1):1-12. doi:10.4193/Rhino50E2.
[2] 罗向前. 中国慢性鼻-鼻窦炎患者多中心临床特征调查[D]. 广州: 中山大学, 2014.
[3] Batra PS, Tong LY, Citardi MJ. Analysis of comorbidities and objective parameters in refractory chronic rhinosinusitis[J]. Laryngoscope, 2013, 123(Suppl 7):S1-S11. doi:10.1002/lary.24418.
[4] Katotomichelakis M, Simopoulos E, Zhang N, et al. Olfactory dysfunction and asthma as risk factors for poor quality of life in upper airway diseases[J]. Am J Rhinol Allergy, 2013, 27(4):293-298. doi:10.2500/ajra.2013.27.3903.
[5] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组, 中华医学会耳鼻咽喉头颈外科学分会鼻科学组. 慢性鼻-鼻窦炎诊断和治疗指南(2012年, 昆明)[J]. 中华耳鼻咽喉头颈外科杂志, 2013, 48(2):92-94. doi: 10.3969/j.issn.1008-1070.2013.11.049. Guidelines for diagnosis and treatment of chronic rhinitis and nasal sinusitis(2012, Kunming)[J]. Chin J Otorhinolaryngol Head Neck Surg, 2013, 48(2):92-94. doi: 10.3969/j.issn.1008-1070.2013.11.049.
[6] Bousquet J, Van Cauwenberge P, Khaltaev N, et al. Allergic rhinitis and its impact on asthma[J]. J Allergy Clin Immunol, 2001, 108(Suppl5):S147-S334.
[7] Annesi-Maesano I. Epidemiological evidence of the occurrence of rhinitis and sinusitis in asthmatics[J]. Allergy, 1999, 54(Suppl 57):7-13.
[8] Bachert C, Vignola AM, Gevaert P, et al. Allergic rhinitis, rhinosinusitis, and asthma: one airway disease[J]. Immunol Allergy Clin North Am, 2004, 24(1):19-43. doi:10.1016/S0889-8561(03)00104-8.
[9] Jani AL, Hamilos DL. Current thinking on the relationship between rhinosinusitis and asthma[J]. J Asthma, 2005, 42(1):1-7.
[10] 李华斌,赖玉婷.慢性鼻-鼻窦炎的发病机制及诊疗进展[J].山东大学耳鼻喉眼学报,2018,32(3):4-9. doi: 10.6040/j.issn.1673-3770.1.2018.004. LI Huabin, LAI Yuting. Pathogenesis,diagnosis,and treatment of chronic rhinosinusitis [J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32(3):4-9. doi: 10.6040/j.issn.1673-3770.1.2018.004.
[11] Lemière C, Ernst P, Olivenstein R, et al. Airway inflammation assessed by invasive and noninvasive means in severe asthma: eosinophilic and noneosinophilic phenotypes[J]. J Allergy Clin Immunol, 2006, 118(5):1033-1039. doi:10.1016/j.jaci.2006.08.003.
[12] 刘锦铭. 限制性通气功能障碍肺功能指标特点[J]. 中国实用内科杂志, 2012, 32(8):578-580. LIU Jinming. Lung function characteristics of restrictive ventilatory dysfunction[J]. Chin J Prac Intern Med, 2012, 32(8):578-580.
[13] Zhang LH, Zhang L, Zhang CH, et al. The lung function impairment in non-atopic patients with chronic rhinosinusitis and its correlation analysis[J]. Clin Exp Otorhinolaryngol, 2016, 9(4):339-345. doi:10.21053/ceo.2015.01641.
[14] Kariya S, Okano M, Oto T, et al. Pulmonary function in patients with chronic rhinosinusitis and allergic rhinitis[J]. J Laryngol Otol, 2014, 128(3):255-262. doi:10.1017/S0022215114000450.
[15] Lewis SA, Pavord ID, Stringer JR, et al. The relation between peripheral blood leukocyte counts and respiratory symptoms, atopy, lung function, and airway responsiveness in adults[J]. Chest, 2001, 119(1):105-114. doi: 10.1378/chest.119.1.105.
[16] Rohde G, Gevaert P, Holtappels G, et al. Increased IgE-antibodies to Staphylococcus aureus enterotoxins in patients with COPD[J]. Respir Med, 2004, 98(9):858-864. doi: 10.1016/j.rmed.2004.02.012.
[1] 张宇,宋西成. 慢性鼻窦炎伴鼻息肉与哮喘的相关性机制及治疗策略研究进展[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 49-52.
[2] 杜经纬,冯俊,马鹏,李志勇,李红光. 鼻腔冲洗联合鼻用糖皮质激素对AR患者FeNO、肺功能及生活质量的影响[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 124-127.
[3] 齐岩,刘俊其,彭舒娅,罗凯,张名霞,王振霖. 鼻内镜下选择性翼管神经切断术对伴有变应性鼻炎的慢性鼻窦炎的疗效观察[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 109-113.
[4] 余洪猛,刘琢扶,戴琪. 合并哮喘的慢性鼻-鼻窦炎的鼻内镜手术治疗[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 38-41.
[5] 王建伟,张宇,宋西成. 慢性鼻-鼻窦炎伴鼻息肉合并哮喘患者肺功能分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 103-108.
[6] 宋晓宇, 张宇, 李成林, 宋西成. 加速康复外科理念在慢性鼻-鼻窦炎伴鼻息肉手术治疗中的应用[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 9-12.
[7] 黄远,巴罗,李波,余文兴,杨芳丽,杜进涛. 慢性鼻窦炎鼻息肉中转录因子NKX2-1调控嗜酸性炎症反应的作用[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 17-23.
[8] 陈望兴,赵雪,刘岩,刘悦,金春顺. 鼻中隔偏曲及慢性鼻窦炎鼻息肉患者的精神心理状态调查[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 24-27.
[9] 黄凯丰. 糖皮质激素短疗程雾化吸入对嗜酸粒细胞性鼻窦炎伴鼻息肉患者鼻部症状及肾上腺皮质功能的影响[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 28-31.
[10] 李华斌, 赖玉婷. 慢性鼻-鼻窦炎的发病机制及诊疗进展[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 4-9.
[11] 于倩倩,关鸽,张念凯,李娜,温君凤,刘婷婷,连媛媛. 鼻腔嗅裂区呼吸道上皮腺瘤样错构瘤的CT影像表现[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 76-81.
[12] 李宏梅,王兰,高照慧,王莹,薛金梅. p-ERK2及ERK2在鼻息肉组织的表达及其意义[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 42-46.
[13] 张劼,龚齐. 不同分型慢性鼻-鼻窦炎患者外周血嗜酸性粒细胞与中性粒细胞百分比及变态反应临床差异性分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 54-57.
[14] 甘彬,张永举,许安廷. BRF2在慢性鼻-鼻窦炎伴鼻息肉发病过程中的作用研究[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 47-53.
[15] 龚齐,张劼,赵屏屏. 鼻腔扩容术对慢性鼻-鼻窦炎伴睡眠呼吸暂停[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 52-55.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 杨长亮,黄治物,姚行齐,诸勇,孙艺 . 正常气骨导听性脑干反应及其应用[J]. 山东大学耳鼻喉眼学报, 2006, 20(1): 9 -13 .
[2] 万俐佳,鲁海涛,姜义道,刘 辉,李 琴,佘腊枝 . 改良腭咽成形术治疗阻塞性睡眠呼吸暂停综合征41例[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 204 -205 .
[3] 刘 艳,刘新义,王金平,李大健 . 后鼓室解剖结构测量观察及临床意义[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 218 -221 .
[4] 于青青 综述,王跃建 审校 . 硬质耳内镜的临床应用进展[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 222 -224 .
[5] 刘强和,罗香林,耿宛平,陈 晨,雷 迅,刘芳贤,邓 明 . 快速老化小鼠的听功能和耳蜗螺旋神经元的增龄性变化[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 215 -217 .
[6] 杨淑娟,袁 英,刘付星,秦海平 . 美宝湿润烧伤膏联合蛋膜贴补治疗外伤性鼓膜穿孔40例[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 227 -227 .
[7] 林峰,梁勇,卢永田,万丽霞 . 鼻内翻性乳头状瘤临床分型和术式选择[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 231 -233 .
[8] 赵 敏,王守森,甄泽年,陈贤明,王茂鑫 . 鼻内镜联合显微镜行蝶窦及经蝶鞍区微创手术[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 244 -245 .
[9] 楼正才,楼放毅,金忠海 . 咽异感症405例病因分析[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 271 -275 .
[10] 于志良,王卫卫,王明华 . 耳鼻喉综合动力系统切除会厌囊肿23例[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 278 -279 .