慢性鼻窦炎患者中变应性因素的临床研究
|
摘要
目的:探讨慢性鼻-鼻窦炎(CRS)的病因与变应性因素的关系。方法:选取97例CRS患者为试验组,并按照1997年海口标准进行分型(Ⅰ型30例,Ⅱ型32例,Ⅲ型35例);20例鼻中隔偏曲患者为对照组。两组之间分别进行血清学指标检测,以SPSS20.0统计软件进行统计学分析。结果:(1)与对照组相比,外周血嗜酸性粒细胞、血清总IgE(TIgE)、血清特异性IgE(sIgE)在Ⅰ型CRS患者中的表达差异无统计学意义(P>0.05),在Ⅱ、Ⅲ型CRS患者中表达差异有统计学意义(P<0.05);(2)97例CRS患者中变应原检测阳性结果 53例;(3)67例Ⅱ、Ⅲ型CRS患者鼻息肉组织切片结果显示有52例为嗜酸性粒细胞浸润,其中Ⅲ型患者居多。结论:CRS与变态反应有一定的相关性,抗过敏治疗可能预防或降低CRS的发生。
Objective: To investigate the correlation between the etiology of chronic rhinosinusitis(CRS) and allergic factors.Methods: Ninety-seven cases of patients with CRS as the experimental group were selected and classified by the Haikou standard in1997(type Ⅰ 30 cases,type Ⅱ 32 cases, type Ⅲ 35 cases), 20 cases of patients with nasal septum deviation(except allergy history) as the control group,and related serology testing was performed. SPSS20.0 software was used to analyze the data. Results:(1)Compared with control group, the peripheral blood eosinophilia, serum total IgE, serum specific Ig E expression in type Ⅰ CRS were not significantly different(P >0.05), but expression in type Ⅱ and Ⅲ patients showed significant difference(P < 0.05).(2) In 97 cases of patients with CRS, the positive detection of allergen was 53 cases.(3) In 67 cases of type Ⅱ and Ⅲ CRS,pathological results showed that there were 52 cases of eosinophilic infiltration, and the majority of patients were type Ⅲ patients. Conclusion: CRS has certain correlation with allergic reaction and appropriate allergic treatment may prevent or reduce the occurrence of CRS.
Objective: To investigate the correlation between the etiology of chronic rhinosinusitis(CRS) and allergic factors.Methods: Ninety-seven cases of patients with CRS as the experimental group were selected and classified by the Haikou standard in1997(type Ⅰ 30 cases,type Ⅱ 32 cases, type Ⅲ 35 cases), 20 cases of patients with nasal septum deviation(except allergy history) as the control group,and related serology testing was performed. SPSS20.0 software was used to analyze the data. Results:(1)Compared with control group, the peripheral blood eosinophilia, serum total IgE, serum specific Ig E expression in type Ⅰ CRS were not significantly different(P >0.05), but expression in type Ⅱ and Ⅲ patients showed significant difference(P < 0.05).(2) In 97 cases of patients with CRS, the positive detection of allergen was 53 cases.(3) In 67 cases of type Ⅱ and Ⅲ CRS,pathological results showed that there were 52 cases of eosinophilic infiltration, and the majority of patients were type Ⅲ patients. Conclusion: CRS has certain correlation with allergic reaction and appropriate allergic treatment may prevent or reduce the occurrence of CRS.
引文
[1]中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组,中华医学会耳鼻咽喉头颈外科学分会鼻科学组.慢性鼻-鼻窦炎诊断和治疗指南(2012年,昆明)[J].中华耳鼻咽喉头颈外科杂志,2013,48(2):92
[2]刘争,王恒,陆翔,等.慢性鼻-鼻窦炎海口标准有效性的主、客观评估[J].华中科技大学学报(医学版).2007,36(5):681
[3]Nikakhlagh S,Ghafourian-Boroujerdnia M,Saki N,et al.Immunologic factors in patients with chronic polypoid sinusitis[J].Niger J Med,2010,19(3):316
[4]中华耳鼻咽喉头颈外科杂志编委会,中华医学会耳鼻咽喉头颈外科学分会鼻科学组.慢性鼻-鼻窦炎诊断和治疗指南(2008年,南昌)[J].中华耳鼻咽喉头颈外科杂志,2009,44(1):6
[5]程雷.变应性鼻炎的诊断和治疗[J].山东大学耳鼻喉眼学报,2013,27(2):1
[6]Jacobsen E A,Ochkur S I,Lee N A,et al.Eosinophils and asthma[J].Curr Allergy Asthma Rep,2007,7(1):18
[7]孔维佳.耳鼻咽喉头颈外科学[M].北京:人民卫生出版社,2008:318-319
[8]李康,张志茂,杨静.嗜酸性粒细胞在鼻息肉中的相关性研究[J].国际耳鼻咽喉头颈外科杂志,2012,36(3):153
[9]Saitoh T,Kusunoki T,Yao T,et al.Relationship between epithelial damage or basement membrane thickness and eosinophilic infiltration in nasal polyps with chronic rhinosinusitis[J].Rhinology,2009,47(3):275
[10]刘亦青,李红,纪宏志,等.165例慢性鼻-鼻窦炎患者变应性相关临床资料分析[J].山东大学耳鼻喉眼学报,2011,25(6):74
[11]Newman L J,Platts-Mills T A,Phillips C D,et al.Chronic sinusitis.Relationship of computed tomographic findings to allergy,asthma,and eosinophilia[J].JAMA,1994,271(5):363
[12]陆汉强,黄秋生,朱习文.慢性鼻窦炎和鼻息肉患者血清中总Ig E、ECP表达及意义[J].齐齐哈尔医学院学报,2010,31(21):3368
[13]王晓凤,周学军,苏炳泽,等.慢性鼻-鼻窦炎患者特异性Ig E水平与手术治疗效果的关系[J].广东医学,2013,34(11):1703
[14]中华耳鼻咽喉头颈外科杂志编委会鼻科组,中华医学会耳鼻咽喉头颈外科学分会鼻科学组.变应性鼻炎特异性免疫治疗专家共识[J].中华耳鼻咽喉头颈外科杂志,2011,46(12):976
[15]Emanuel I A,Shah S B.Chronic rhinosinusitis:allergy and sinus computed tomography relationships[J].Otolaryngol Head Neck Surg,2000,123(6):687
[2]刘争,王恒,陆翔,等.慢性鼻-鼻窦炎海口标准有效性的主、客观评估[J].华中科技大学学报(医学版).2007,36(5):681
[3]Nikakhlagh S,Ghafourian-Boroujerdnia M,Saki N,et al.Immunologic factors in patients with chronic polypoid sinusitis[J].Niger J Med,2010,19(3):316
[4]中华耳鼻咽喉头颈外科杂志编委会,中华医学会耳鼻咽喉头颈外科学分会鼻科学组.慢性鼻-鼻窦炎诊断和治疗指南(2008年,南昌)[J].中华耳鼻咽喉头颈外科杂志,2009,44(1):6
[5]程雷.变应性鼻炎的诊断和治疗[J].山东大学耳鼻喉眼学报,2013,27(2):1
[6]Jacobsen E A,Ochkur S I,Lee N A,et al.Eosinophils and asthma[J].Curr Allergy Asthma Rep,2007,7(1):18
[7]孔维佳.耳鼻咽喉头颈外科学[M].北京:人民卫生出版社,2008:318-319
[8]李康,张志茂,杨静.嗜酸性粒细胞在鼻息肉中的相关性研究[J].国际耳鼻咽喉头颈外科杂志,2012,36(3):153
[9]Saitoh T,Kusunoki T,Yao T,et al.Relationship between epithelial damage or basement membrane thickness and eosinophilic infiltration in nasal polyps with chronic rhinosinusitis[J].Rhinology,2009,47(3):275
[10]刘亦青,李红,纪宏志,等.165例慢性鼻-鼻窦炎患者变应性相关临床资料分析[J].山东大学耳鼻喉眼学报,2011,25(6):74
[11]Newman L J,Platts-Mills T A,Phillips C D,et al.Chronic sinusitis.Relationship of computed tomographic findings to allergy,asthma,and eosinophilia[J].JAMA,1994,271(5):363
[12]陆汉强,黄秋生,朱习文.慢性鼻窦炎和鼻息肉患者血清中总Ig E、ECP表达及意义[J].齐齐哈尔医学院学报,2010,31(21):3368
[13]王晓凤,周学军,苏炳泽,等.慢性鼻-鼻窦炎患者特异性Ig E水平与手术治疗效果的关系[J].广东医学,2013,34(11):1703
[14]中华耳鼻咽喉头颈外科杂志编委会鼻科组,中华医学会耳鼻咽喉头颈外科学分会鼻科学组.变应性鼻炎特异性免疫治疗专家共识[J].中华耳鼻咽喉头颈外科杂志,2011,46(12):976
[15]Emanuel I A,Shah S B.Chronic rhinosinusitis:allergy and sinus computed tomography relationships[J].Otolaryngol Head Neck Surg,2000,123(6):687