鼻窦炎伴鼻息肉嗜酸性粒细胞浸润对患者嗅觉恢复的影响

Effect of Sinusitis with Nasal Polyp Eosinophil Infiltration on Olfactory Recovery in Patients

目的评价嗜酸性粒细胞(Eos)浸润对鼻窦炎伴鼻息肉(CRSwNP)临床症状及治疗效果的影响。方法选择124例CRSwNP患者为研究对象,术后病理EosⅠ度28例,Ⅱ度36例,Ⅲ度31例,Ⅳ度29例。评价不同Eos分度患者鼻窦CT Lund-Mackay评分、嗅觉VAS评分及治疗后复发。结果术前鼻窦CT Lund-Mackay评分评价结果显示,患者术前Lund-Mackay评分随Eos浸润上升显著增加,术后VAS随Eos浸润上升降低,差异有统计学意义(P<0.001)。术后有效性判定结果显示,Ⅰ度、Ⅱ度、Ⅲ度及Ⅳ度患者有效率分别为100.0%、100.0%、9.7%与79.3%,Ⅳ度患者有效率显著降低(P<0.05);随访结果显示,Ⅰ度、Ⅱ度、Ⅲ度及Ⅳ度患者复发率分别为3.6%、8.3%、22.5%与27.6%,Ⅲ度及Ⅳ度复发率显著上升(P<0.05)。结论Eos浸润可影响CRSwNP患者临床表现及预后转归,应增强临床及治疗,减少术后复发。

Objective To evaluate the effect of eosinophil(Eos)infiltration on the clinical symptoms and therapeutic effects of sinusitis with nasal polyps(CRSwNP).Methods A total of 124 patients with CRSwNP were enrolled.The postoperative pathological Eos Ⅰ degree was 28 cases,Ⅱ degree 36 cases,Ⅲ degree 31 cases,and Ⅳ degree 29 cases.Patients with different Eos index were evaluated for CT Lund-Mackay score,olfactory VAS score and recurrence after treatment.Results The preoperative sinus CT Lund-Mackay score showed that the preoperative Lund-Mackay score increased significantly with Eos infiltration,and the postoperative VAS decreased with Eos infiltration(P<0.001).The results of postoperative efficacy showed that the effective rates of patients with grade Ⅰ,Ⅱ,Ⅲ and Ⅳ were 100.0%,100.0%,9.7% and 79.3%,respectively,and the effective rate of IV patients was significantly lower(P<0.05).The results showed that the recurrence rates of patients with gradeⅠ,Ⅱ,Ⅲ and Ⅳ were 3.6%,8.3%,22.5%and 27.6%,respectively,and the recurrence rates of grade Ⅲ and Ⅳ were significantly increased(P<0.05).Conclusion Eos infiltration can affect the clinical manifestations and prognosis of patients with CRSwNP.It should enhance clinical and treatment and reduce postoperative recurrence.