伴与不伴鼻息肉的慢性鼻-鼻窦炎患者生存质量比较

Comparison of life quality between chronic rhinosinusitis patients with and without nasal polyps

目的探讨伴鼻息肉的慢性鼻-鼻窦炎(CRSwNP)和不伴鼻息肉的慢性鼻-鼻窦炎(CRSs NP)患者生存质量的差异。方法选取2017年1月至2017年6月安徽省立医院的慢性鼻-鼻窦炎患者100例,依据欧洲鼻-鼻窦炎鼻息肉诊疗指南,分为CRSwNP组50例,CRSs NP组50例,运用Lund-Mackay CT评分及Lund-Kennedy鼻内镜评分对客观病情进行评估,采用汉化版生存质量评定量表(SF-36)及视觉模拟评分量表(VAS)对主观生存质量进行评估,分析两组患者生存质量差异。结果 (1)CRSwNP组的Lund-Mackay CT评分(13.71±6.60)分及Lund-Kennedy鼻内镜评分(8.38±2.81)分均高于CRSs NP组的Lund-Mackay CT评分(8.11±6.45)分及Lund-Kennedy鼻内镜评分(4.78±2.08)分,差异均有统计学意义(P<0.05);(2)CRSwNP组的VAS总体评分(19.55±8.02)分与CRSs NP组(19.21±9.65)分相比,差异无统计学意义(P>0.05),但CRSs NP组的头痛、面部胀痛症状[(3.70±3.10)分、(3.72±3.01)分]高于CRSwNP组[(0.98±1.83)分、(0.55±1.18)分],鼻塞、嗅障碍症状评分[(4.19±3.28)分、(2.72±3.51)分]低于CRSwNP组[(6.65±3.24)分、(7.23±3.36)分],差异均有统计学意义(P<0.05);(3)CRSwNP组SF-36量表躯体健康总分(PCS)(319.21±54.34)分与CRSs NP组(295.22±70.52)分相比,差异无统计学意义(P>0.05),但CRSs NP组的生理职能(RF)(64.27±39.04)分低于CRSwNP组(79.42±28.54)分,差异有统计学意义(P<0.05);(4)CRSwNP组SF-36量表精神健康总分(MCS)(306.79±67.52)分与CRSs NP组(286.24±86.02)分相比,差异无统计学意义(P>0.05),但CRSs NP组活力(VI)、精神健康(MH)[(66.39±23.32)分、(66.98±21.14)分]低于CRSwNP组[(76.51±16.49)分、(76.65±17.48)分],差异均有统计学意义(P<0.05)。结论客观病情方面,CRSwNP患者较CRSs NP患者更为严重,但生理职能、活力及精神健康方面,CRSsNP患者较CRSwNP患者下降更为显著,应注意提高客观病情轻但主观生活质量差的患者生活质量。

Objective To explore the difference of life quality between those chronic rhinosinusitis patients with nasal polyps(CRSwNP)and without nasal polyps(CRSsNP).Methods One hundred patients with chronic rhinosinusitis,ever treated in our hospital from Jan 2017 to Jun 2017,were collected and divided into the CRSwNP group(n=50)and the CRSsNP group(n=50)according to the EuropeanPosition Paper on Rhinosinusitis and Nasal Polyp.The Lund-Mackay CT grading system and Lund-Kennedy nasal endoscopic grading system were used to evaluate the objective conditions of all patients.Their subjective qualities of life were evaluated by means of Chinese versions of visual analogue scale(VAS)and life quality scale(SF-36),and then the difference of life quality between the two groups were analyzed.Results The Lund-Mackay CT score and Lund-Kennedy endoscopic score in the CRSwNP group[(13.71±6.60),(8.38±2.81)]were significantly higher than those scoresin the CRSsNP group[(8.11±6.45),(4.78±2.08);P<0.05].Although there was no significant difference in the overall VAS scores between the CRSwNP and CRSsNP groups[(19.55±8.02),(19.21±9.65);P>0.05],but the VAS scores of CRSsNP patients with symptoms ofheadache and facial pain[(3.70±3.10),(3.72±3.01)]were significantly higher than the scores of corresponding CRSwNP patients[(0.98±1.83),(0.55±1.18);P<0.05],whereas the VAS scores of CRSsNP patients with symptoms of nasal obstruction and olfactory disturbance[(4.19±3.28),(2.72±3.51)]were significantly lower than the scores of corresponding CRSwNP patients[(6.65±3.24),(7.23±3.36);P<0.05].The physical component summary(PCS)scores of SF-36 scale in the CRSwNP and CRSsNP groups were(319.21±54.34)and(295.22±70.52),and their difference was of no significance(P>0.05),but the physiological function(RF)scores in the CRSsNP patients was significantly lower than those in the CRSwNP patients[(64.27±39.04)vs(79.42±28.54);P<0.05].The mental component summary(MCS)scores of SF-36 scale in the CRSwNP and CRSsNP groupswere(306.79±67.52)and(286.24±86.02),with no significant difference between them(P>0.05),but the vitality(VI)and mental health(MH)scores in the CRSsNP group[(66.39±23.32),(66.98±21.14)]were significantly lower than those scores in the CRSwNP group[(76.51±16.49),(76.65±17.48);P<0.05].Conclusion In the objective condition,patients in the CRSwNP group are more serious than those in the CRSsNP group,but in the physiological function,vitality and mental health,patients with CRSsNP may have more evident reduction than those with CRSwNP.So,improvement of life quality should be noted for those patients with mild objective illness and poor subjective quality of life.