慢性鼻-鼻窦炎伴鼻息肉的炎性亚型与其共患病哮喘黏膜炎性表型的相关性研究

张敏; 王建亭; 武大伟; 谭丽萍

doi:10.13201/j.issn.1001-1781.2018.01.010

慢性鼻-鼻窦炎伴鼻息肉的炎性亚型与其共患病哮喘黏膜炎性表型的相关性研究

- 1. 首都医科大学附属北京朝阳医院耳鼻咽喉头颈外科(北京, 100020);
- 2. 首都医科大学附属北京安贞医院耳鼻咽喉头颈外科
基金项目:
北京市自然科学基金资助项目（No：7152057）；首都临床特色应用研究（No：Z151100004015050）

详细信息

通讯作者: 王建亭,E-mail:tingjw@126.com

中图分类号: R765.21

收稿日期: 2017-11-04

The study of association of chronic rhinosinusitis inflammation subtype with bronchial inflammation phenotype

- 1. Department of Otolaryngology Head and Neck Surgery, Chaoyang Hospital, Capital Medical University, Beijing, 100020, China;
- 2. Department of Otolaryngology Head and Neck Surgery, Anzhen Hospital, Capital Medical University

More Information

Corresponding author: WANG Jianting, E-mail: tingjw@126.com

Received Date: 04 November 2017

摘要

摘要: 目的：比较不同炎性亚型慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）伴哮喘的临床特点并探讨鼻息肉炎性亚型与其共患病哮喘黏膜炎性表型的相关性。方法：选取51例明确诊断为CRSwNP伴哮喘并且有鼻内镜手术适应证的患者（≥ 18岁）为研究对象。术前行血常规检查及鼻窦CT、皮肤点刺试验、气道激发试验、肺功能及呼出气一氧化氮（FeNO）检查。术中取鼻息肉组织进行苏木精-伊红染色，根据嗜酸粒细胞在鼻息肉中的浸润特点分为嗜酸性慢性鼻-鼻窦炎伴鼻息肉（ECRSwNP）组和非嗜酸性慢性鼻-鼻窦炎伴鼻息肉（non-ECRSwNP）组，并评估鼻息肉组织嗜酸粒细胞的浸润程度。结果：51例CRSwNP伴哮喘的患者分为ECRSwNP组（n=33）和non-ECRSwNP组（n=18）。鼻内镜手术翻修率、变应反应率、鼻窦Lund-Mackay积分、哮喘病程、严重哮喘百分率、前一年哮喘的发作次数、FeNO、血嗜酸粒细胞百分率和绝对值在ECRSwNP组较non-ECRSwNP组显著增高（P<0.05）。血嗜酸粒细胞的百分率与鼻息肉嗜酸粒细胞的浸润程度（r=0.459，P<0.01）、FeNO （r=0.591，P<0.01）呈正相关，鼻息肉嗜酸粒细胞的浸润程度与FeNO （r=0.556，P<0.01）呈显著正相关。鼻窦Lund-Mackay积分和血嗜酸粒细胞百分率呈正相关（r=0.327，P<0.05），鼻息肉嗜酸粒细胞浸润程度（r=0.412，P<0.01）及FeNO （r=0.691，P<0.01）呈显著正相关。结论：不同炎性亚型的CRSwNP伴哮喘有不同的临床特点，CRSwNP的炎性亚型与共患病哮喘黏膜炎性亚型有相关性。
- 慢性鼻-鼻窦炎 /
- 鼻息肉 /
- 哮喘 /
- 嗜酸粒细胞 /
- 炎症
Abstract: Objective: We sought to compare clinical characteristics between eosinophilic and non-eosinophilic chronic rhinosinusitis with nasal polyps (CRSwNP) and asthma, and explored the association of chronic rhinosinusitis inflammation subtypewith bronchial inflammation phenotype in CRSwNP with asthma.Method: Fifty-one consecutive patients suffering from CRSwNP with asthma undergoing endoscopic sinus surgery (ESS) were recruited. Preoperative computed tomography (CT), skin-prick test, bronchial provocation test, lung function, and oral fractional exhaled nitric oxide (FeNO) measurements were conducted. Venous blood was taken within 1 week before ESS. Nasal polyps (NPs) specimens were obtained from each patient during ESS, and stained with hematoxylin and eosin. According to the pathologic characteristics of NP samples, fifty-one patients suffering from CRSwNP with asthma were grouped as eosinophilic CRSwNP (ECRSwNP) and non-ECRSwNP and three levels of eosinophil infiltration were recognized.Result: Fifty-one patients suffering from CRSwNP with asthma were grouped as ECRSwNP (n=33) and non-ECRSwNP (n=18). History of surgery, history of allergy, Lund-Mackay scores, duration of asthma, frequency of severity asthma, numbers of asthma exacerbation in the last year, FeNO, blood eosinophil percentage and absolute count were all significantly higher in the ECRSwNP with asthma group compared with the non-ECRSwNP with asthma group (P<0.05). Blood eosinophil percentage had a significant correlation with degree of eosinophil infiltration in NPs (r=0.459, P<0.01) and FeNO (r=0.591, P<0.01). There was a correlation between degree of eosinophil infiltration in NPs and FeNO (r=0.556, P<0.01). Furthermore, Lund-Mackay scores had a positive correlation with blood eosinophil percentage (r=0.327, P<0.05) and degree of eosinophil infiltration in NPs (r=0.412, P<0.01) and FeNO (r=0.691, P<0.01).Conclusion: There is different clinical characteristics between ECRSwNP with asthma and non-ECRSwNP with asthma. These data suggest that CRSwNP inflammation subtype is significantly correlated with bronchial inflammation phenotype in patients suffering from CRSwNP with asthma.
- chronic rhinosinusitis /
- nasal polyps /
- asthma /
- eosinophils /
- inflammation

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