慢性鼻窦炎伴鼻息肉患者嗅觉障碍严重程度的影响因素分析

Analysis of influence factors for olfactory dysfunctions in patients with chronic rhinosinusitis with nasal polyps

目的探讨慢性鼻窦炎伴鼻息肉(chronic rhinosinusitis with nasal polyps,CRSwNP)患者嗅觉障碍严重程度的影响因素。方法行鼻内镜手术的CRSwNP患者43例,根据术前T&T嗅觉识别阈值分为嗅觉丧失组(24例)与嗅觉减退组(19例),对可能影响CRSwNP嗅觉障碍严重程度的相关因素进行分析。结果单因素分析,Lund-Mackey评分、嗅裂前区评分(anterior olfactory cleft score,AOCS)、嗅裂后区评分、上鼻甲黏膜嗜酸性粒细胞数、上鼻甲黏膜嗅觉标记蛋白(olfactory marker protein,OMP)阳性细胞数在两组间比较有统计学差异(P均<0.05)。Logistic回归分析,AOCS是CRSwNP患者嗅觉障碍严重程度的独立危险因素,上鼻甲黏膜OMP阳性细胞数越多,CRSwNP患者嗅觉障碍加重的风险越小。结论AOCS、上鼻甲黏膜OMP阳性细胞数与CRSwNP患者嗅觉障碍的严重程度密切相关。

OBJECTIVE To invest igate the factors inf luencing olfactory dysfunctions in patients with chronic rhinosinusitis with nasal polyps(CRSwNP).METHODS 43 patients with CRSwNP who underwent nasal endoscopic surgery were divided into anosmia group(n=24)and hyposmia group(n=19),according to preoperative T&T olfactory recognition threshold.The factors which have influence on olfactory dysfunctions were analyzed by logistic regression.RESULTS The univariate analysis showed that Lund-Mackey score,anterior olfactory cleft score(AOCS),posterior olfactory cleft score,eosinophil count of superior turbinate and olfactory marker protein(OMP)positive cell count of superior turbinate were significantly different between the two groups(all P<0.05).Multivariate logistic analysis showed that AOCS was an independent risk factor for the aggravation of olfactory dysfunctions in patients with CRSwNP,and the more OMP-positive cells there are in upper turbinate mucosa,the less severe the olfactory disorders are in patients with CRSwNP.CONCLUSION AOCS and the number of OMP positive cells in superior turbinate mucosa were associated with the extent of olfactory dysfunctions in CRSwNP patients.