改良鼻内镜评分及ELR值与慢性鼻窦炎伴鼻息肉亚分型的相关性分析

Correlation analysis between modified nasal endoscopic score and ELR value and subtype of chronic sinusitis with nasal polyps

目的:分析改良鼻内镜评分及ELR值等相关检查指标与慢性鼻窦炎(CRS)伴鼻息肉亚分型的相关性。方法:回顾性分析119例CRS伴鼻息肉患者的临床资料,根据术后病理结果分为嗜酸粒细胞性CRS伴鼻息肉(eCRSwNP)组及非嗜酸粒细胞性CRS伴鼻息肉(neCRSwNP)组。对所有患者进行改良鼻内镜检查评分,结合临床及解剖特征分别进行中鼻道区和嗅裂区评分;同期记录哮喘、AR病史及血常规中嗜酸细胞百分比(EO%)、嗜酸细胞绝对值(EO#)、中性粒细胞绝对值(N)、淋巴细胞绝对值(R)、总IgE,并计算中性粒细胞与淋巴细胞比率(NLR)、嗜酸粒细胞与淋巴细胞比率(ELR)。采用SPSS 19.0软件对相关数据进行统计学分析。结果:根据改良的鼻内镜评分标准,相比neCRSwNP组,eCRSwNP组嗅裂区评分显著较高而中鼻道区评分显著较低;ELR值、EO%及EO#在eCRSwNP组中明显高于neCRSwNP组,而NLR值及N值在neCRSwNP组中更高(P<0.05);2组年龄、性别、R值、总IgE比较差异无统计学意义。ELR值与EO#比较,具有稳定性、敏感度更高等优点。因此,嗅裂区息肉及ELR值对预诊断的意义更大。结论:改良鼻内镜评分及ELR值与CRSwNP的亚分型具有明显相关性,鼻内镜下鼻息肉发生于嗅裂区,其ELR值升高、NLR值降低,且伴发AR、哮喘等,可作为有创病理、CT检查前eCRSwNP的预诊断指标。

Objective:To analyze the correlation between the modified nasal endoscopic score and ELR value and the subtype of chronic sinusitis with nasal polyps.Method:The clinical data of 119patients of chronic sinusitis with nasal polyps were retrospectively analyzed.According to the postoperative pathological results,they were divided into two groups:eosinophilic chronic sinusitis with nasal polyps(eCRSwNP)and non-eosinophilic chronic sinusitis with nasal polyps(neCRSwNP).All patients underwent modified nasal endoscopic examination scores,according to clinical features and anatomical features into the part of the middle nasal meatus and the part of olfactory fissure,and the scores were calculated in two areas respectively;History of asthma,allergic rhinitis and the percentage of eosinophils(EO%),the absolute value of eosinophils(EO#),the absolute neutrophil(N),the absolute lymphocyte(R),the total IgE were recorded at the same time.Calculate the NLR value and ELR value.This study used SPSS 19.0for statistical analysis of relevant data.Result:According to the modified nasal endoscopic scoring criteria,the eCRSwNP group had significantly higher olfactory fissure area scores while middle nasal meatus area scores were significantly lower than the neCRSwNP group;ELR value,EO%and EO#were significantly higher in the eCRSwNP group than in the control group,while NLR value and N value were higher in the neCRSwNP group(P<0.05);There was no significant difference in age,gender,R value and total IgE between the two groups.Compared with EO#,the ELR value was more stability and sensitivity.Therefore,the olfactory fissure area polyps and ELR value are more significant for pre-diagnosis.Conclusion:The modified nasal endoscopic score and ELR value are more correlated with the subtype of CRSwNP.Higher ELR value,lower NLR value,and association with allergic rhinitis,asthma can be used as prediagnostic indicators for eCRSwNP before invasive pathological results and CT examination.