嗜酸性粒细胞与慢性鼻-鼻窦炎合并鼻息肉的临床特征的关系

Relationship of clinical characteristics between eosinophils and chronic rhinosinusitis with nasal polyp

目的探讨嗜酸性粒细胞(Eos)与慢性鼻-鼻窦炎伴鼻息肉(CRSw NP)的临床特征的关系。方法 62例慢性鼻-鼻窦炎伴鼻息肉并行鼻内镜下鼻窦开放手术患者,根据外周血嗜酸性粒细胞比例,分为Eos组与正常密度嗜酸性粒细胞(NEos)组。比较两组患者鼻息肉组织嗜酸性粒细胞计数、鼻腔鼻窦结局测量20条(SNOT-20)评分以及鼻窦CT的Lund-Mackay评分等。结果 Eos组鼻息肉组织中的嗜酸性粒细胞计数显著高于NEos组(P<0.05);Eos组的SNOT-20评分略低于NEos组,差异无统计学意义(P>0.05),鼻息肉组织中嗜酸性粒细胞计数与SNOT-20评分无相关性(r=0.246,P=0.126>0.05);两组CT的Lund-Mackay评分比较差异有统计学意义(P<0.05);外周血嗜酸性粒细胞比例与组织病理学结果呈正相关(r=0.512,P<0.05),ROC曲线下面积(AUC)为0.808,截断值为3.65%,其对嗜酸性粒细胞性慢性鼻-鼻窦炎合并鼻息肉(ECRSw NP)诊断的灵敏度和特异度分别为78.9%和71.4%。结论嗜酸性粒细胞影响慢性鼻-鼻窦炎合并鼻息肉的临床特征,ECRSw NP诊断时注意外周血嗜酸性粒细胞的比例,从而为患者制定合适的治疗策略。

Objective To investigate relationship of clinical characteristics between eosinophils（Eos） and chronic rhinosinusitis with nasal polyp（CRSw NP）. Methods A total of 62 chronic rhinosinusitis with nasal polyp patients receiving endoscopic sinus open surgery were divided by peripheral blood eosinophils proportion into Eos group and normal density Eos（NEos） group. Comparison was made on eosinophils count in polyp tissue, sino-nasal outcome test-20（SNOT-20） score and Lund-Mackay score of nasal sinus CT between the two groups. Results Eos group had obviously higher eosinophils count in polyp tissue than NEos group（P〈0.05）. Eos group had lower SNOT-20 score than NEos group, and the difference had no statistical significance（P〉0.05）. Eosinophils count in polyp tissue and SNOT-20 was not correlated（r=0.246, P=0.126〉0.05）. The difference of CT Lund-Mackay scores had statistical significance between the two groups（P〈0.05）. Peripheral blood eosinophils proportion was positively correlated with histopathological outcome（r=0.512, P〈0.05）. Area under curve（AUC） of ROC was 0.808, with cutoff value as 3.65%. It contained sensitivity and specificity as 78.9% and 71.4% in diagnosis of eosinophils chronic rhinosinusitis with nasal polyp（ECRSw NP）. Conclusion Eosinophils has effects on clinical characteristics of chronic rhinosinusitis with nasal polyp. It is necessary to pay attention to peripheral blood eosinophils proportion in diagnosing ECRSw NP, in order to make appropriate treatment strategy for patients.