真菌球型鼻窦炎发病因素及与鼻腔解剖异常的相关性

Pathogenic factors of fungal ball sinusitis and its correlation with nasal anatomic abnormalities

目的:通过对真菌球型鼻窦炎(fungal ball sinusitis,FBS)患者数据的回顾分析,探寻其发病的高危因素,以及与鼻中隔偏曲的相关性研究,为临床有效的预防及诊疗提供新策略。方法:采用病例对照研究设计,选取2019年1月至2023年12月安徽医科大学附属合肥医院45例FBS患者作为FBS组,同时随机选取同期入院的45例慢性鼻窦炎(chronic rhinosinusitis,CRS)患者作为CRS组。回顾性收集两组患者的病史、临床信息及实验室检查数据进行分析,比较两组间临床资料的差异,并分析FBS患者患病侧与鼻中隔偏曲的关系。结果:FBS共45例,平均年龄52.44岁,合并糖尿病11例,高血压12例;CRS组共45例,平均年龄46.98岁,合并糖尿病3例,高血压6例,组间比较年龄及是否合并糖尿病差异有统计学意义(P<0.05)。FBS组的空腹血糖水平高于CRS组,而淋巴细胞百分比及白细胞计数低于CRS组,组间比较有显著差异(P<0.05)。FBS组内比较,鼻中隔偏曲侧与鼻窦患病侧具有相关性,而烟酒史未见与FBS发病有明显相关性。结论:年龄、糖尿病、白细胞计数、淋巴细胞占比可能是FBS发病的影响因素,鼻中隔偏曲可能影响FBS局部的发生、进展。

Objective Through the retrospective analysis of the data of patients with fungal ball sinusitis,in order to provide a new strategy for the effective prevention and diagnosis of FBS in the clinic.Methods Using a case-control study design,45 patients with FBS in Hefei Hospital of Anhui Medical University from January 2019 to December 2023 were chosen as the observational group,while 45 cases of chronic rhinosinusitis(CRS)admitted to the hospital during the similar period were at random chosen as the comparison group.Retrospective collection and analysis were conducted on the respective medical histories,clinical details,and lab test data of both groups,followed by a comparison of the clinical information variances between them.Comparison of the differences in clinical data between the two groups,as well as evaluation of the association between the area of disease and septal deviation in patients with FBS.Results There were 45 cases of FBS,with a mean age of 52.44 years,11 with diabetic complications and 12 with hypertension.Within the CRS cohort,the average age of 45 individuals was 46.98 years,accompanied by 3 instances of diabetes mellitus and 6 of hypertension;A statistical significance(P<0.05)was found between age and diabetes mellitus when contrasting the two groups.There was a statistically notable disparity(P<0.05)in the levels of blood glucose,leukocytes,and lymphocyte percentages between the two groups in the FBS group.During the intergroup analysis of FBS,a notable statistical variance was observed between the side with a deviated septum and the one with diseased sinuses,as determined by the chi-square test(P<0.05).And the history of smoking and alcohol did not see a significant correlation with the development of FBS.Conclusions Age,diabetes mellitus,leukocyte count,and lymphocyte percentage may be the influencing factors for the development of FBS,and there is a positive correlation between the side of FBS prevalence and the side of deviated septum,suggesting that deviated septum may affect the occurrence and progression of FBS localization.