山东大学耳鼻喉眼学报 ›› 2020, Vol. 34 ›› Issue (6): 16-20.doi: 10.6040/j.issn.1673-3770.0.2019.388

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慢性鼻-鼻窦炎伴鼻息肉患者组织嗜酸性粒细胞与嗅觉功能障碍的相关性研究

陶丹丹,董红军,褚云锋,黄超,胡磊   

  1. 张家港市中医医院 耳鼻咽喉科, 江苏 张家港 215600
  • 发布日期:2021-01-11
  • 通讯作者: 董红军. E-mail:704932537@qq.com
  • 基金资助:
    江苏省卫生计生委2017年医学科研课题面上项目(H201758);苏州市临床重点病种诊疗技术专项基金(LCZX201723)

Correlation between eosinophils and olfactory dysfunction in patients with CRSwNP after nasal operation

TAO Dandan, DONG Hongjun, CHU Yunfeng, HUANG Chao, HU Lei   

  1. Department of Otolaryngology, Zhangjiagang Traditional Chinese Medicine Hospital, Zhangjiagang 215600, Jiangsu, China
  • Published:2021-01-11

摘要: 目的 探讨慢性鼻-鼻窦炎伴鼻息肉(CRSwNP)患者术后组织嗜酸性粒细胞与嗅觉功能障碍的相关性。 方法 回顾性选择2016年7月至2018年7月CRSwNP行鼻内镜鼻窦手术(ESS)治疗的120例患者。通过视觉模拟评分(VAS)和Lund-Kennedy评分了解患者病情;术后取筛窦黏膜组织进行嗜酸性粒细胞计数。通过Sniffin'Sticks测试和化学感觉事件相关电位(CSERP)来评估嗅觉功能。Spearman相关分析用以了解嗜酸性粒细胞计数与Sniffin'Sticks测试和CSERP参数之间的关系及VAS评分和CSERP的相关性。 结果 调整协变量(年龄、性别、饮酒、吸烟、过敏性鼻炎、哮喘、术后时间和Lund-Kennedy评分)后的相关性分析结果与未调整协变量的结果一致。组织嗜酸性粒细胞计数与阈值评分相关(r=-0.460,P=0.012);组织嗜酸性粒细胞计数与苯乙醇(N1:r=0.471,P=0.010; P2:r=-0.487,P=0.007)及乙醇(N1:r=-0.516,P=0.008; P2:r=-0.590,P=0.002)刺激产生的CSERP峰值潜伏期N1和P2相关;但与CSERP振幅均无明显相关(P>0.05)。苯乙醇刺激产生的阈值评分和CSERP峰值潜伏期N1之间存在明显负相关(r=-0.560,P<0.001)。乙醇刺激产生的CSERP潜伏期与症状VAS评分存在明显负相关(r=-0.400,P=0.005)。 结论 CRSwNP患者鼻术后组织嗜酸性粒细胞增多与术后嗅觉功能障碍明显相关,且三叉神经的敏感性可能与组织嗜酸性粒细胞增多相关,鼻黏膜炎症可同时影响嗅神经及三叉神经的功能。

关键词: 慢性鼻-鼻窦炎伴鼻息肉, 嗜酸性粒细胞, 嗅觉功能, 相关性

Abstract: Objective To investigate the association between postoperative tissue eosinophils and olfactory dysfunction in patients with chronic rhinosinusitis and nasal polyps(CRSwNP). Methods A retrospective study of 120 patients who underwent CRSFNP endoscopic sinus surgery(ESS)between July 2016 and July 2018 was performed. The conditions of the patients were graded with the VAS and Lund-Kennedy scores; the eosinophil counts of the sinus mucosa were obtained. Olfactory function was assessed using the Sniffin' Sticks test and chemosensory event-related potential(CSERP). Spearman correlation analysis was used to determine the relationship between eosinophil count and the Sniffin' Sticks test results and CSERP parameters as well as the correlation between the VAS score and CSERP. Results The correlation analysis results after adjustment for covariates(age, gender, alcohol consumption, smoking, allergic rhinitis, asthma, postoperative time, and Lund-Kennedy score)were consistent with the results of the unadjusted covariates. The tissue eosinophil counts were associated with the threshold scores(r=-0.460, P=0.012): tissue eosinophil count and phenylethyl alcohol(N1: r=0.471, P=0.010; P2: r=-0.487, P=0.007)and ethanol(N1: r=-0.516, P=0.008; P2: r=-0.590, P=0.002). The peak latency of CSERP induced by stimulation was related to N1 and P2; however, it showed no significant correlation with the CSERP amplitude(P>0.05). There was a significant negative correlation between the threshold score generated by phenylethyl alcohol stimulation and the CSERP peak latency(N1: r=-0.560, P<0.001). There was a significant negative correlation between the CSERP latency generated by ethanol stimulation and the symptomatic VAS score(r=-0.400, P=0.005). Conclusions Postoperative tissue eosinophilia in patients with CRSwNP is significantly associated with postoperative olfactory disturbance, and the sensitivity of the trigeminal nerve may be associated with tissue eosinophilia. Inflammation of the nasal mucosa may affect the function of the olfactory and trigeminal nerves.

Key words: Chronic rhinosinusitis with nasal polyps, Eosinophil, Olfactory, Correlation

中图分类号: 

  • R765.4
[1] Cao YJ, Chen FH, Sun YQ, et al. LL-37 promotes neutrophil extracellular trap formation in chronic rhinosinusitis with nasal polyps[J]. Clin Exp Allergy, 2019, 49(7): 990-999. doi:10.1111/cea.13408.
[2] Philpott C, le Conte S, Beard D, et al. Clarithromycin and endoscopic sinus surgery for adults with chronic rhinosinusitis with and without nasal polyps: study protocol for the MACRO randomised controlled trial[J]. Trials, 2019, 20(1): 246. doi:10.1186/s13063-019-3314-7.
[3] 王明甫. 鼻内镜手术治疗慢性鼻窦炎后症状无缓解的处理与相关因素分析[J]. 中国现代手术学杂志, 2014, 18(6): 468-470. doi:10.16260/j.cnki.1009-2188.2014.06.025. WANG Mingfu. Clinical survey of symptoms non-improvement after endoscopic surgery for chronic sinusitis[J]. Chinese Journal of Modern Operative Surgery, 2014,18(6): 468-470. doi:10.16260/j.cnki.1009-2188.2014.06.025.
[4] Li YM, Tan GJ, Liu J, et al. The role of relaxin-2 in tissue remodeling of chronic rhinosinusitis with nasal polyps[J]. Am J Rhinol Allergy, 2019, 33(5): 490-499. doi:10.1177/1945892419843828.
[5] Weibman AR, Huang JH, Stevens WW, et al. A prospective analysis evaluating tissue biopsy location and its clinical relevance in chronic rhinosinusitis with nasal polyps[J]. Int Forum Allergy Rhinol, 2017, 7(11): 1058-1064. doi:10.1002/alr.22005.
[6] Dobretsov K, Negm H, Ralli M, et al. The theory of a “Staphylococcus superantigen” in chronic rhinosinusitis with nasal polyps: myth or reality [J]. Eur Rev Med Pharmacol Sci, 2019, 23(1 Suppl): 48-54. doi:10.26355/eurrev_201903_17349.
[7] Olszewska A, Niewiadomski P, Olszewski J. Influence of nasal mucosa irritants on the occurrence of chronic rhinosinusitis without /and with polyps[J]. Pol Otolaryngol, 2020, 74(5): 1-5. doi:10.5604/01.3001.0014.2047.
[8] Blaiss MS. Chronic rhinosinusitis with nasal polyps management in the age of biologics[J]. Allergy Asthma Proc, 2020, 41(6): 413-419. doi:10.2500/aap.2020.41.200069.
[9] Choi MR, Xu J, Lee S, et al. Chloroquine treatment suppresses mucosal inflammation in a mouse model of eosinophilic chronic rhinosinusitis[J]. Allergy Asthma Immunol Res, 2020, 12(6): 994-1011. doi:10.4168/aair.2020.12.6.994.
[10] Wang SB, Chen SM, Zhu KS, et al. Increased lipopolysaccharide content is positively correlated with glucocorticoid receptor-beta expression in chronic rhinosinusitis with nasal polyps[J]. Immun Inflamm Dis, 2020, 8(4): 605-614. doi:10.1002/iid3.346.
[11] Chen FQ, Wen LT, Qiao L, et al. Impact of allergy and eosinophils on the morbidity of chronic rhinosinusitis with nasal polyps in northwest China[J]. Int Arch Allergy Immunol, 2019, 179(3):209-214. doi:10.1159/000497384.
[12] 张丽川, 孙敬武, 胡春华, 等. 慢性鼻窦炎伴鼻息肉患者嗅觉障碍的影响因素分析[J]. 中华耳鼻咽喉头颈外科杂志, 2020, 55(4): 350-357. doi:10.3760/cma.j.cn115330-20190614-00383. ZHANG Lichuan, SUN Jingwu, HU Chunhua, et al. Analysis of factors affecting olfactory disfunctions in patients with chronic rhinosinusitis with nasal polyps[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2020, 55(4): 350-357. doi:10.3760/cma.j.cn115330-20190614-00383.
[13] Prazma CM, Bel EH, Price RG, et al. Oral corticosteroid dose changes and impact on peripheral blood eosinophil counts in patients with severe eosinophilic asthma: a post hoc analysis[J].Respir Res, 2019, 20(1): 83. doi:10.1186/s12931-019-1056-4.
[14] Yancey SW, Bradford ES, Keene ON. Disease burden and efficacy of mepolizumab in patients with severe asthma and blood eosinophil counts of ≥150-300 cells/μL[J]. Respir Med, 2019, 151: 139-141. doi:10.1016/j.rmed.2019.04.008.
[15] Chen SY, Li ZT, Wang L. Cutaneous mastocytoma associated with abundant eosinophil infiltration and flame figures[J]. J Cutan Pathol, 2019, 46(6): 397-400. doi:10.1111/cup.13452.
[16] Imran TF, Kurgansky KE, Patel YR, et al. Serial sodium values and adverse outcomes in heart failure with preserved ejection fraction[J]. Int J Cardiol, 2019, 290: 119-124. doi:10.1016/j.ijcard.2019.03.040.
[17] Yan B, Lou HF, Wang Y, et al. Epithelium-derived cystatin SN enhances eosinophil activation and infiltration through IL-5 in patients with chronic rhinosinusitis with nasal polyps[J]. JAllergy Clin Immunol, 2019, 144(2): 455-469. doi:10.1016/j.jaci.2019.03.026.
[18] Mac Donald MI, Osadnik CR, Bulfin L, et al. Low and high blood eosinophil counts as biomarkers in hospitalized acute exacerbations of COPD[J]. Chest, 2019, 156(1): 92-100. doi:10.1016/j.chest.2019.02.406.
[19] Yamada T, Miyabe Y, Ueki S, et al. Eotaxin-3 as a plasma biomarker for mucosal eosinophil infiltration in chronic rhinosinusitis[J]. Front Immunol, 2019, 10: 74. doi:10.3389/fimmu.2019.00074.
[20] Shen KC, Lin YT, Lin CF, et al. Allergy accelerates the disease progression of chronic rhinosinusitis[J]. Acta Otolaryngol, 2019, 139(1): 75-79. doi:10.1080/00016489.2018.1552368.
[21] 李红英, 孙克峰, 皮丽宏, 等. 慢性鼻-鼻窦炎患者嗅觉功能与鼻内镜评分、鼻窦CT评分的相关性[J]. 临床与病理杂志, 2017, 37(7): 1434-1437. doi:10.3978/j.issn.2095-6959.2017.07.019. LI Hongying, SUN Kefeng, PI Lihong, et al. Correlation of olfactory function with nasal endoscopy score and sinus CT score of patients with chronic rhinosinusitis[J]. International Journal of Pathology and Clinical Medicine, 2017, 37(7): 1434-1437. doi:10.3978/j.issn.2095-6959.2017.07.019.
[22] Mitroi M, Albulescu D, Capitanescu A, et al. Differences in the distribution of CD20, CD3, CD34 and CD45RO in nasal mucosa and polyps from patients with chronic rhinosinusitis[J]. Mol Med Rep, 2019, 19(4): 2792-2800. doi:10.3892/mmr.2019.9932.
[23] Guo M, Alasousi F, Okpaleke C, et al. Prognosis of chronic rhinosinusitis with nasal polyps using preoperative eosinophil/basophil levels and treatment compliance[J]. Am J Rhinol Allergy, 2018, 32(5): 440-446. doi:10.1177/1945892418793523.
[24] McHugh T, Snidvongs K, Xie M, et al. High tissue eosinophilia as a marker to predict recurrence for eosinophilic chronic rhinosinusitis: a systematic review and meta-analysis[J]. Int Forum Allergy Rhinol, 2018, 8(12): 1421-1429. doi:10.1002/alr.22194.
[25] Poletti SC, Cuevas M, Weile S, et al. Trigeminal sensitivity in chronic rhinosinusitis: topographical differences and the effect of surgery[J]. Rhinology, 2017, 55(1): 70-74. doi:10.4193/Rhin16.194.
[26] Saliba J, Fnais N, Tomaszewski M, et al. The role of trigeminal function in the sensation of nasal obstruction in chronic rhinosinusitis[J]. Laryngoscope, 2016, 126(5): E174-E178. doi:10.1002/lary.25952.
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