变态反应对慢性鼻-鼻窦炎内镜鼻窦手术疗效的相关性探讨

Investigation of the correlation of the surgical efficacy between allergic reaction and chronic sinusitis

目的探讨变态反应性因素对慢性鼻-鼻窦炎(CRS)内镜鼻窦手术(FESS)疗效的影响。方法术前对118例CRS患者进行变态反应性因素血清相关指标测定:血清总IgE浓度、血清特异性变应原IgE半定量检测(SIgE),术后规范服药和规范换药。以海口鼻科会议制定的疗效评定标准(以鼻内镜检查为准)评定临床效果。结果 23例未愈组患者血清IgE阳性率73.91%,血清SIgE阳性率65.22%,95例痊愈组患者血清IgE阳性率6.32%,血清SIgE阳性率4.21%,两组比较,差异有统计学意义(P<0.05)。结论变态反应性因素对CRS患者主客观疗效有一定的负面影响,血清总IgE浓度增高与血清SIgE浓度增高且伴鼻息肉的患者手术效果不佳。本研究结果为CRS的免疫治疗提供了一定依据。

Objective To investigate the effect of allergic factors on chronic nasal sinusitis （a CRS） endoscopic sinus operation （FESS）. Methods Before operation, 118 cases of CRS patients were examined for the related indicators of allergic factors in serum： total serum IgE concentration, serum specific allergen semi quantitative IgE （SIgE）. Postoperative standardized medication and standard dressing. The efficacy evaluation followed the standard established by Haikou nasal Conference （with nasal endoscopy for evaluation of clinical effectiveness）. Results 23 cases of failure in patients with IgE positive rate was 73.91%, the positive rate of SIgE in serum 65.22%, 95 cases were cured in the patients with IgE positive rate was 6.32%, the positive rate of SIgE in serum 4.21%. Conclusion Allergic factors on CRS patients＇ subjective and objective outcome of a certain negative effect, total serum IgE concentration increased with the concentration of serum SIgE increased and with nasal polyps in patients with poor therapeutic effect prompt operation. The study of CRS immunotherapy provides certain basis.