慢性鼻-鼻窦炎鼻息肉组织及外周血嗜酸细胞与临床表现的关系

Clinical examination of tissue and blood eosinophilia in chronic rhinosinusitis with nasal polyps

目的探讨慢性鼻-鼻窦炎伴鼻息肉(chronic rhinosinusitiswith nasal polyps,CRSwNP)患者组织及外周血中嗜酸细胞(eosinophils,Eos)计数的相关性,并研究Eos与鼻窦影像学表现及术后复发的关系。方法回顾性分析102例确诊为CRSwNP患者的临床资料,对鼻息肉组织进行Eos计数,比较其与外周血Eos的相关性。根据术后1年随访结果,比较复发组与非复发组之间的组织及外周血Eos计数、鼻窦CTLund-Mackay评分的统计学差异。结果复发组外周血Eos计数、外周血Eos百分数以及鼻息肉组织Eos计数显著高于非复发组(P=0.032、0.033、0.017),两组的鼻窦CT评分无统计学差异(P=0.089)。鼻息肉组织Eos计数与外周血Eos绝对值具有显著相关性(r=0.637,P=0.000);鼻息肉组织Eos计数与外周血Eos百分比也具有显著相关性(r=0.542,P=0.000);外周血Eos计数、Eos百分数、鼻息肉组织Eos计数与术前鼻窦CT评分无显著相关性(P=0,072、0.065、0.695)。结论外周血及鼻息肉组织Eos计数具有显著相关性,并且鼻息肉组织及外周血Eos计数与鼻息肉术后复发相关。

OBJECTIVE To analyze the correlation between number of tissue eosinophils（Eos） and blood Eos levels in patients with chronic rhinosinusitis with nasal polyps（CRSwNP）, and to investigate if tissue and blood eosinophilia predicts disease severity and prognosis in CRSwNP. METHODS A retrospective analysis of 102 patients, who diagnosed with CRSwNP was carried out in this study. Surgical specimens were evaluated for degree of tissue Eos, which was compared with blood Eos. Patients were divided into two groups according to the results of endoscopy one year after surgery： recurrent and non-recurrent group. Statistical analysis was performed to compare tissue and blood Eos and CT Lurid-Mackay scores. RESULTS Blood and tissue Eos in recurrent group was significantly higher than that in non-recurrent group（P=0.032, 0.033, 0.017）. There was not a statistical difference of CT scores between two groups（P=0.089）. There was a significant correlation between tissue Eos and absolute number of blood Eos（r=0.637, P=0.000） as well as between tissue Eos and percentage of blood Eos（r=0.542, P=0.000）. However Eos and CT scores were not correlated statistically（P〉0.05）. CONCLUSION Blood Eos levels can predict the degree of Eos infiltration in nasal polyps. Blood and tissue Eos correlate with prognosis.