嗜酸性粒细胞性慢性鼻窦炎粘膜炎症与手术疗效的相关性

The Relationship between the Inflammation of Mucosa and the Curative Effect of Eosinophilic Chronic Sinusitis

目的探讨嗜酸性粒细胞性慢性鼻窦炎患者的粘膜炎症和其手术疗效之间的关系.方法 2014年9月至2017年9月,选取曲靖市第二人民医院收治的30例嗜酸性粒细胞性慢性鼻窦炎患者作为研究对象,对其鼻窦组织石蜡标本行HE染色,显微镜观察计算炎症细胞数目以及其中含有的嗜酸性粒细胞数目,判定嗜酸性粒细胞的浸润程度,对患者手术治疗效果评估,分析嗜酸性粒细胞的浸润程度和临床分型之间的关系.结果 30例慢性鼻窦炎患者术后1~2周病变黏膜相关嗜酸性粒细胞的浸润程度为3级、4级所占百分比较手术前明显降低(χ2=7.687 6,P=0.005 5);术后4~6周病变黏膜相关嗜酸性粒细胞的浸润程度为3级、4级所占百分比较手术前,无显著差异性(χ2=0.326 7,P=0.567 6);术后10~12周病变黏膜相关嗜酸性粒细胞的浸润程度为3级、4级所占百分比对比于手术前明显降低(χ2=13.484 2,P=0.000 2).30例慢性鼻窦炎患者病变黏膜相关嗜酸性粒细胞浸润程度为1级的治疗有效率较浸润程度为3级、4级明显提升(χ2=23.099 0、23.099 0,P=0.000 0、0.000 0);慢性鼻窦炎患者病变黏膜相关嗜酸性粒细胞浸润程度为2级的治疗有效率较浸润程度为3级、4级明显提升(χ2=12.281 7、12.281 7,P=0.000 4、0.000 4).临床分型为1型中,浸润程度1级、浸润程度2级均有分布,无浸润程度3级、浸润程度4级;临床分型为2型中,浸润程度1级最多,浸润程度2级、浸润程度3级、浸润程度4级均有分布;临床分型为3型中,浸润程度1级最多,浸润程度2级、浸润程度3级、浸润程度4级均有分布.浸润程度1级和2级的临床分型为2型所占百分比较浸润程度3级、4级,数据没有出现显著差异性改变(χ2=0.380 1、0.380 1和0.380 1、0.380 1,P=0.537 5、0.537 5和0.537 5、0.537 5).结论嗜酸性粒细胞性慢性鼻窦炎患者的粘膜炎症和其手术疗效之间具有一定的相关性.

Objective To explore the relationship between the mucosal inflammation and the surgical efficacy of patients with eosinophilic chronic sinusitis. Me thods From September 2014 to September 2017, 30 patients with chronic eosinophils sinusitis were selected in our hospital. We colored the sinus tissue paraffin specimens by HE staining, calculated the number of inflammatory cells by microscope observation and the number of eosinophils contained, determined the eosinophil infiltration degree, evaluated the effect of surgical treatment, and analyzed the eosinophil infiltration degree and the relationship between the clinical classification.Re s ults The infiltration degree of the mucosa related eosinophilic granulocytes was significantly lower（χ^27.6876, P =0.0055） after1-2 weeks after surgery for patients with chronic sinusitis. The degree of infiltration of the mucosa related eosinophilic granulocytes at 4 weeks and 6 weeks after surgery was 3 and 4. There was no significant difference before surgery（χ^20.3267,P=0.5676）. The degree of infiltration of the mucosa related eosinophils in the 10-12 weeks after surgery was significantly lower than that in grade 3 and 4（χ^213.4842,P=0.0002）. In 30 patients with chronic sinusitis, the treatment efficiency of the mucosa associated eosinophilic granulocytic infiltration level was level 3 and level 4（χ^2 23.0990, 23.0990,P= 0.0000, 0.0000）. The treatment efficiency of the lesion of the mucosa of patients with chronic sinusitis was level 2 and the level of infiltration was 3 and 4（χ^212.2817,12.2817,P =0.0004, 0.0004）. In the clinical fractal type 1, the degree of infiltration level 1 and 2 was distributed, and the degree of infiltration level 3 and 4 was absent; In the clinical fractal type 2, the degree of infiltration level 1 was mostly observed and the degree of infiltration level 2, 3 and 4 was distributed; In the clinical fractal type 3,the degree of infiltration level 1 was mostly observed and the degree of infiltration level 2, 3 and 4 was distributed. The comparison between infiltration degree level 1 and level 2 of the total clinical classification and the type 2 percentage infiltration degree level 3 and level 4 was not significant（χ^20.3801, 0.3801 and 0.3801,0.3801,P=0.5375, 0.5375, 0.5375, 0.5375）. Conclusion There is a certain relationship between the mucosal inflammation and the curative effect of eosinophilic chronic sinusitis.