不同体质量指数的慢性鼻窦炎伴鼻息肉患者临床特征分析

Clinical characteristics of chronic rhinosinusitis with nasal polyps with different body mass index

目的分析不同体质量指数(body mass index,BMI)的慢性鼻窦炎伴鼻息肉(chronic rhinosinusitis with nasal polyps,CRSwNP)患者的临床特征。方法回顾性分析2013至2019年共448例CRSwNP接受鼻内镜手术患者(病例组)和308例接受鼻中隔偏曲手术的无其他鼻部疾病的患者(对照组)的临床资料。按照BMI级别分为非超重组(BMI<25.0kg/m^(2))、超重&肥胖组(BMI≥25.0kg/m^(2)),结合性别再次分组,比较各组合并哮喘及再手术率的差异。结果CRSwNP患者外周血嗜酸性粒细胞百分比及伴过敏史比例均高于对照组,差异有统计学意义(P<0.05)。女性CRSwNP患者合并哮喘比例高于男性患者组(31.6%vs 20.7%),男性超重患者多于女性,差异均有统计学意义(P<0.05)。女性超重&肥胖的患者再次手术率为43.6%,高于非超重患者,外周血嗜酸性粒细胞百分比明显低于非超重组患者,差异均有统计学意义(P<0.05)。男性超重&肥胖患者外周血嗜酸性粒细胞百分比低于非超重患者,差异有统计学意义(P<0.05)。结论女性超重&肥胖的CRSwNP患者更容易合并哮喘和复发,控制CRSwNP患者体质量可能对预防女性CRSwNP患者的复发和缓解病情有积极意义。

Objective To analysis the clinical characteristics in chronic rhinosinusitis with nasal polyps(CRSwNP)patients with different level of body mass index(BMI).Methods A total of 448 CRSwNP patients and 308 controls with septal deviation in Beijing Tongren Hospital from^(2)013 to 2019 were recruited retrospectively.According to BMI levels,CRSwNP patients were divided into 2 groups:underweight&normal weight(BMI<25 kg/m^(2))or overweight&obese(BMI≥25 kg/m^(2)),and the rate of asthma comorbidity and revision surgery were analyzed.Results The percentage of eosinophilis in peripheral blood and the allergy comorbidity rate in CRSwNP patients were significantly higher than those in control group(P<0.05).Further classified the patients by genders,the female patients had higher rate of asthma comorbidity(31.6%vs 20.7%),and male overweight&obese CRSwNP patients were more than female overweight&obese patients.Classified the patients by BMI levels and gender,revision surgery rate of female overweight&obese CRSwNP patients was 43.6%,which was significantly higher than that of female underweight and normal weight patients.The percentage of eosinophil in peripheral blood in female overweight&obese patients was significantly lower than that in underweight and normal weight patients.The percentage of eosinophil in peripheral blood of male overweight&obese patients was significantly lower than that of underweight and normal weight patients.Conclusions The overweight and obesity female CRSwNP patients were susceptible to be with comorbid asthma and recurrence after surgery,and controlling the weight of female patients with CRSwNP may prevent nasal polyps recurrence in the females.