慢性鼻-鼻窦炎变应原特征初步探讨

Preliminary study of allergen features in chronic rhinosinusitis

目的探讨变应原在慢性鼻-鼻窦炎(CRS)伴或不伴鼻息肉患者中的分布特点及临床意义。方法回顾性分析CRS患者136例,比较伴鼻息肉组及不伴息肉组患者的变应原特征。以变应性鼻炎(AR)患者36例为对照组,分析CRS与AR变应原的差异。结果 CRS患者变应原总阳性率为48.5%,其两种亚型在变应原阳性率、吸入性和食物变应原分布比例、各类变应原分布比例、单一和多种变应原分布比例均无显著性差异(P>0.05)。CRS致敏原主要为单纯吸入性变应原(84.8%),食物变应原致敏者较少(9.1%),少数为吸入物和食物混合型变应原(6.1%)。与AR相比,CRS的吸入性和食物变应原分布比例(χ~2=14.801,P=0.001)、变应原亚类(χ~2=12.951,P=0.005)以及单一或多种变应原(χ~2=9.067,P=0.003)方面均有显著性差异。结论 CRS患者变应原阳性率远高于过敏性疾病的普通人群患病率,提示变应性因素可能与CRS的发病有着密切的相关性。CRS伴有或不伴有息肉,其变应原的临床特征相似,但与AR的变应原特征有显著性差异。变应原的检测可能对CRS的预防和治疗有一定的指导意义。

OBJECTIVE To invest igate the distribution features and clinical significance of allergens inpatients with chronic rhinosinusitis（CRS）. METHODS A retrospective analysis was performed in 136 cases of CRS. Allergen features were compared in the two subtypes of CRS： chronic rhinosinusitis with nasal polyps（CRSwNP）and chronic rhinosinusitis without nasal polyps（CRSsNP）.Differences of allergens features of CRS were analyzed, and they were compared to the allergens of 36 patients with allergic rhinitis（AR）. RESULTS The total allergen positive rate in CRS was 48.5%. The allergen positive rate, distribution proportion of inhaled and food allergens, distribution proportion of allergens subsets, distribution proportion of single and multiple allergens between two subtypes of CRS had no significant difference（P 0.05）. The major allergens of CRS were single inhaled allergens（84.8%）.Some CRS patients were allergic to food allergen（9.1%）.The minority allergens of CRS were a mixture of inhaled and food allergens（6.1%）. Compared to AR, the distribution proportion of inhaled and food allergens（ χ-2=14.801,P =0.001）, the dist r ibut ion propor t ion of allergens subsets（χ-2=12.951, P =0.005）, and the distribution proportion of single and multiple allergens（ χ-2=9.067, P =0.003） had significant difference. CONCLUSION The allergen positive rate of CRS is much higher than the prevalence of allergic diseases in general population, suggesting that allergic factors may be closely correlated to the pathogenesis of CRS. The clinical features of allergens are similar in the two subtypes of CRS, while there are significant differences in allergen distribution between CRS and AR patients. The detection of allergens may be helpful in prevention and treatment of CRS.