鼻息肉与变应性鼻炎对慢性鼻-鼻窦炎主客观量化评估的影响

陈丽鸿; 刘成刚; 江洪

doi:10.13201/j.issn.1001-1781.2018.01.011

鼻息肉与变应性鼻炎对慢性鼻-鼻窦炎主客观量化评估的影响

- 1. 重庆医科大学附属永川医院耳鼻咽喉头颈外科(重庆永川, 402160);
- 2. 重庆医科大学附属永川医院眼科
基金项目:
重庆医科大学附属永川医院2015年度院内科研课题（No：YJLCX201538）

详细信息

通讯作者: 江洪,E-mail:jh55966@aliyun.com

中图分类号: R765.41

收稿日期: 2017-11-03

Effects of nasal polyps and allergy rhinitis on quantitative evaluation of subjective and objective assessment of chronic rhinosinusitis

- 1. Department of Otolaryngology-Head and Neck Surgery, Yongchuan Hospital of Chongqing Medical University, Yongchuan, 402160, China;
- 2. Department of Ophthalmology, Yongchuan Hospital of Chongqing Medical University

More Information

Corresponding author: JIANG Hong, E-mail: jh55966@aliyun.com

Received Date: 03 November 2017

摘要

摘要: 目的：探讨鼻息肉、变应性鼻炎对慢性鼻-鼻窦炎主客观病情评估的影响，并分析主观和客观评分的相关性。方法：收集2016-06-2017-06期间收治的253例慢性鼻-鼻窦炎患者，总结患者相关病史资料，将所有患者分为伴或不伴鼻息肉组、伴或不伴嗜酸粒细胞（EOS）增多组、伴或不伴变应性鼻炎组，分别采用视觉模拟量表（VAS）、Lund-Mackay CT评分表及Lund-Kennedy鼻内镜评分评估病情，统计分析各组及合并组3种评分的差异，分析每组内患者3种评分间的相关性。结果：253例慢性鼻-鼻窦炎患者纳入分析，多发生在41~65岁，各年龄段男女差异有统计学意义（P<0.01）。伴鼻息肉组VAS评分、CT及鼻内镜评分均高于不伴鼻息肉组（P<0.05）；伴变应性鼻炎组鼻内镜评分高于不伴组（P<0.01）；伴EOS增多组VAS评分、CT及鼻内镜评分高于不伴组（P>0.05）。不伴变应性鼻炎或EOS增多组的VAS评分与鼻内镜或CT评分间均呈正相关（P<0.01），而伴有组无相关性（P>0.05）；在鼻息肉、变应性鼻炎、EOS增多2种或3种因素中同时伴有组主客观评分间无相关性（P>0.05），而不伴组均呈正相关（P<0.01）。结论：慢性鼻-鼻窦炎伴鼻息肉或变应性鼻炎能较显著加重患者的主观感受和客观症状；伴有鼻息肉、变应性鼻炎、EOS增多等变应性因素的患者存在主观症状和客观检查结果的差异。因此临床上应重视变应性因素对患者的影响，采用多种主观和客观评分手段综合评估患者病情，可为慢性鼻-鼻窦炎的个性化诊治提供依据。
- 慢性鼻-鼻窦炎 /
- 鼻息肉 /
- 鼻炎,变应性 /
- 主观评估 /
- 客观评估
Abstract: Objective: To investigate the effect of nasal polyps and allergy rhinitis on disease assessment of chronic rhinosinusitis, and to analyze the correlation between subjective and objective scores.Method: A total of 253 patients with chronic rhinosinusitis were enrolled from June 2016 to June 2017, and the clinical data such as sex, age, comorbidity, diagnosis and treatment were summarized. All patients were grouped as with or without nasal polyps, with or without eosinophilia, with or without allergic rhinitis group, and assessed by the visual analogue scale(VAS), Lund-Mackay CT score and Lund-Kennedy score respectively. The difference of the three grades in each group were analyzed by statistic analysis. The correlation between the three grades was analyzed.Result: Two hundred and fifty-three cases of chronic rhinosinusitis were included in the analysis. There were 143 males and 110 females with an average age of 44.44±15.44 years old, mostly in the 41-65 age group, and the difference was statistically significant (P<0.01). The scores of VAS, Lund-Mackay CT and Lund-Kennedy in the nasal polyp group were significantly higher than those in the non-nasal polyp group (P<0.05). The nasal endoscopy score of patients with allergic rhinitis was higher than that of non-allergic rhinitis group (P<0.01). There was no significant difference between VAS score, CT and endoscopic score in EOS group (P>0.05). There was a positive correlation between VAS score and nasal endoscopy score or CT score (P<0.01) in patients of non-allergic rhinitis or eosinophilia group, but there was no correlation (P>0.05) in patients with allergic rhinitis or eosinophilia group. There was no correlation when two or three factors exist at the same time beteen the nasal polyp, allergic rhinitis and EOS group (P>0.05), whereas show up positive correlation on non-merged group (P<0.01).Conclusion: Chronic rhinosinusitis complicated with nasal polyps or allergic rhinitis can significantly increase the subjective and objective symptoms of patients. There are differences between subjective symptoms and objective tests in the patients with nasal polyps, allergic rhinitis and EOS factors. Therefore, clinical attention should be paid to the impact of allergic factors on patients, using a variety of subjective and objective evaluation atrategies to evaluate the condition of patients with chronic rhinosinusitis comprehensively, to provide a basis for personalized diagnosis and treatment.
- chronic rhinosinusitis /
- nasal polyps /
- rhinitis, allergic /
- subjective assessment /
- objective assessment

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