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

doi:10.6040/j.issn.1673-3770.0.2018.567

摘要/Abstract

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

王亚坤,张宇,宋西成. 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[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 99-102.

WANG Yakun, ZHANG Yu, SONG Xicheng. Analysis of pulmonary function and its influencing factors in chronic rhinosinusitis without lower airway disease[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(1): 99-102.

参考文献 16

[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.

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