目的探讨嗜酸性粒细胞型鼻息肉内镜术中应用全降解鼻窦药物支架对临床疗效的影响。方法入组行鼻内镜手术的嗜酸性粒细胞型鼻息肉患者15例,设计自身对照研究,将双侧鼻腔随机分为支架侧与对照侧。支架侧内镜术中植入全降解鼻窦药物支架;...目的探讨嗜酸性粒细胞型鼻息肉内镜术中应用全降解鼻窦药物支架对临床疗效的影响。方法入组行鼻内镜手术的嗜酸性粒细胞型鼻息肉患者15例,设计自身对照研究,将双侧鼻腔随机分为支架侧与对照侧。支架侧内镜术中植入全降解鼻窦药物支架;对照侧鼻腔未植入全降解鼻窦药物支架。分别于内镜术前,术后2周、1个月、2个月、3个月进行随访评估,主要评估指标为鼻部症状视觉模拟量表评分、Lund-Kennedy鼻内镜评分、黏膜病理嗜酸性粒细胞计数。结果支架侧鼻内镜评分在术后3个月时明显低于对照侧(1.786±1.051 vs 2.643±1.151,t=2.064,P=0.0208);黏膜病理嗜酸性粒细胞计数在术后1个月时显著低于对照侧(61.33±28.50 vs 84.33±27.83,t=3.044,P=0.0088);鼻部症状视觉模拟量表评分双侧无明显差异。结论嗜酸性粒细胞型鼻息肉内镜术中应用全降解鼻窦药物支架可以抑制黏膜炎症,改善鼻内镜评分,促进术腔良性转归。展开更多
目的:探讨嗜酸性粒细胞性慢性鼻窦炎伴鼻息肉(eosinophilic chronic rhinosinusitis with nasalpol-yps,ECRSwNP)患者鼻内镜鼻窦术后症状和体征变化预示复发的可能性。方法:2020年6月至2022年3月连续入组70例ECRSwNP患者在单中心接受双...目的:探讨嗜酸性粒细胞性慢性鼻窦炎伴鼻息肉(eosinophilic chronic rhinosinusitis with nasalpol-yps,ECRSwNP)患者鼻内镜鼻窦术后症状和体征变化预示复发的可能性。方法:2020年6月至2022年3月连续入组70例ECRSwNP患者在单中心接受双侧鼻内镜手术(endoscopicsurgery,ESS)治疗,其中男50例,女20例;平均年龄(46.9±14.5)岁;ESS后随访至少52周。患者进行外周血检查、鼻窦CT、嗅觉T&T测试、症状视觉模拟量表(VAS)和内镜下评分。结果:分析术前、术后6、12、24和52周患者VAS和内镜下评分。发现术后12~52周,患者的症状和内镜下评分呈明显相关关系。12周之后,嗅觉障碍及黏脓涕症状是患者变化最明显的2种症状。在症状控制组和未控制组,患者多项术前临床指标表达均有差异(既往手术史、合并哮喘、鼻分泌物EC、血清EOS%、总IgE、CT、嗅觉及症状评分等,P<0.05),而基线水平的内镜评分无差异(P>0.05)。术后12周之后,2组患者无论是症状评分还是鼻内镜下评分,均表现出明显的差异。随访第12周的症状及内镜评分作为预测复发的指标,其灵敏度和特异度分别为62.5%和83.3%。结论:ECRSwNP患者术后症状评分和内镜下评分的变化均提示病变复发;在未控制组,症状和内镜下评分表现一致的评分增加;而在控制组,患者的内镜评分增加和症状的稳定不变之间出现矛盾结果,提示应小心无症状复发患者的存在。随访第12周的症状及体征改变可以作为预防病变复发的临床指标。展开更多
OBJECTIVES: To study the concentration, distribution and expression of IL-5 in nasal polyp tissues and explore its significance in micro-environment differentiation of eosinophil accumulation. METHODS: The concentrati...OBJECTIVES: To study the concentration, distribution and expression of IL-5 in nasal polyp tissues and explore its significance in micro-environment differentiation of eosinophil accumulation. METHODS: The concentration and expression of IL-5 in nasal polyp tissues of 40 patients were determined by ELISA and immunohistochemistry and inferior turbinate mucosa from patients with nasal polyps and healthy volunteers were used as control. RESULTS: IL-5 concentration in polyp tissues was significantly higher than that in turbinate mucosa (P 0.05). IL-5 concentrations in polyp tissues were markedly higher in patients with allergic rhinitis compared with those without (P 0.05). 80.1% of the eosinophils were positive for IL-5 and 90.9% of IL-5 positive cells were eosinophils. Only 3.7% of lymphocytes and neutrophils were positive for IL-5; IL-5 was not detectable in epithelial cells. IL-5 expression in eosinophils of polyp tissues was remarkably stronger than that of the turbinate mucosa (P 0.05). IL-5 expression of eosinophils in polyp tissue was significantly stronger in patients with allergic rhinitis compared with those without (P 0.05). CONCLUSION: IL-5 is the key cytokine in eosinophilic pathologic mechanisms in nasal polyp tissues.展开更多
文摘目的探讨嗜酸性粒细胞型鼻息肉内镜术中应用全降解鼻窦药物支架对临床疗效的影响。方法入组行鼻内镜手术的嗜酸性粒细胞型鼻息肉患者15例,设计自身对照研究,将双侧鼻腔随机分为支架侧与对照侧。支架侧内镜术中植入全降解鼻窦药物支架;对照侧鼻腔未植入全降解鼻窦药物支架。分别于内镜术前,术后2周、1个月、2个月、3个月进行随访评估,主要评估指标为鼻部症状视觉模拟量表评分、Lund-Kennedy鼻内镜评分、黏膜病理嗜酸性粒细胞计数。结果支架侧鼻内镜评分在术后3个月时明显低于对照侧(1.786±1.051 vs 2.643±1.151,t=2.064,P=0.0208);黏膜病理嗜酸性粒细胞计数在术后1个月时显著低于对照侧(61.33±28.50 vs 84.33±27.83,t=3.044,P=0.0088);鼻部症状视觉模拟量表评分双侧无明显差异。结论嗜酸性粒细胞型鼻息肉内镜术中应用全降解鼻窦药物支架可以抑制黏膜炎症,改善鼻内镜评分,促进术腔良性转归。
文摘目的:探讨嗜酸性粒细胞性慢性鼻窦炎伴鼻息肉(eosinophilic chronic rhinosinusitis with nasalpol-yps,ECRSwNP)患者鼻内镜鼻窦术后症状和体征变化预示复发的可能性。方法:2020年6月至2022年3月连续入组70例ECRSwNP患者在单中心接受双侧鼻内镜手术(endoscopicsurgery,ESS)治疗,其中男50例,女20例;平均年龄(46.9±14.5)岁;ESS后随访至少52周。患者进行外周血检查、鼻窦CT、嗅觉T&T测试、症状视觉模拟量表(VAS)和内镜下评分。结果:分析术前、术后6、12、24和52周患者VAS和内镜下评分。发现术后12~52周,患者的症状和内镜下评分呈明显相关关系。12周之后,嗅觉障碍及黏脓涕症状是患者变化最明显的2种症状。在症状控制组和未控制组,患者多项术前临床指标表达均有差异(既往手术史、合并哮喘、鼻分泌物EC、血清EOS%、总IgE、CT、嗅觉及症状评分等,P<0.05),而基线水平的内镜评分无差异(P>0.05)。术后12周之后,2组患者无论是症状评分还是鼻内镜下评分,均表现出明显的差异。随访第12周的症状及内镜评分作为预测复发的指标,其灵敏度和特异度分别为62.5%和83.3%。结论:ECRSwNP患者术后症状评分和内镜下评分的变化均提示病变复发;在未控制组,症状和内镜下评分表现一致的评分增加;而在控制组,患者的内镜评分增加和症状的稳定不变之间出现矛盾结果,提示应小心无症状复发患者的存在。随访第12周的症状及体征改变可以作为预防病变复发的临床指标。
基金ThisworkwassupportedbytheNationalOutstandingYouthFoundationofChina (No.39725025)andtheNaturalScienceFoundationofGuangdongProvince (No .K 160 )
文摘OBJECTIVES: To study the concentration, distribution and expression of IL-5 in nasal polyp tissues and explore its significance in micro-environment differentiation of eosinophil accumulation. METHODS: The concentration and expression of IL-5 in nasal polyp tissues of 40 patients were determined by ELISA and immunohistochemistry and inferior turbinate mucosa from patients with nasal polyps and healthy volunteers were used as control. RESULTS: IL-5 concentration in polyp tissues was significantly higher than that in turbinate mucosa (P 0.05). IL-5 concentrations in polyp tissues were markedly higher in patients with allergic rhinitis compared with those without (P 0.05). 80.1% of the eosinophils were positive for IL-5 and 90.9% of IL-5 positive cells were eosinophils. Only 3.7% of lymphocytes and neutrophils were positive for IL-5; IL-5 was not detectable in epithelial cells. IL-5 expression in eosinophils of polyp tissues was remarkably stronger than that of the turbinate mucosa (P 0.05). IL-5 expression of eosinophils in polyp tissue was significantly stronger in patients with allergic rhinitis compared with those without (P 0.05). CONCLUSION: IL-5 is the key cytokine in eosinophilic pathologic mechanisms in nasal polyp tissues.
