Clinical characteristics of non-eosinophilic and eosinophilic chronic sinusitis with nasal polyps
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摘要: 目的:探讨非嗜酸粒细胞型慢性鼻窦炎伴鼻息肉(NONEOS CRSwNP)及嗜酸粒细胞型慢性鼻窦炎伴鼻息肉(EOS CRSwNP)的临床特点。方法:收集慢性鼻窦炎伴鼻息肉患者92例,根据病理切片嗜酸粒细胞浸润程度分为EOS CRSwNP、NONEOS CRSwNP 2型,比较2型之间的临床特点。结果:在福建北部地区,NONEOS CRSwNP更为常见(84.8%)。NONEOS CRSwNP具有以下临床特征:①鼻漏多为黏脓性涕;②鼻息肉可见更多脓囊肿;③外周血嗜酸粒细胞占比多在正常范围内;④以上颌窦病变为主。EOSCRSwNP更具以下特点:①鼻漏多为黏性涕;②鼻窦病变双侧多见,以筛窦病变为主;③外周血嗜酸粒细胞占比常升高;④常伴有哮喘,术后鼻息肉易于复发,全身糖皮质激素对其复发性息肉治疗有效。结论:EOS CRSwNP、NONEOS CRSwNP的临床特点存在差异,外周血嗜酸粒细胞比值、术前内镜及CT评估有助于对CRSwNP进行分型。Abstract: Objective: To investigate the clinical characteristics of non-eosinophilic and eosinophilic chronic sinusitis with nasal polyps. Method: Ninty-two patients with chronic sinusitis with nasal polyps were collected and divided into eosinophilic chronic sinusitis with nasal polyps(EOS CRSwNP) and non-eosinophilic chronic sinusitis with nasal polyps(NONEOS CRSwNP) by pathological classification. The clinical characteristics between the two types were compared. Result: NONEOS CRSwNP is more common in northern area of Fujian province(84.8%). NONEOS CRSwNP had the following clinical characteristics: one most nasal discharge was purulent; two more pyocysts can be seen in nasal polyps; three the proportion of eosinophils in the peripheral blood was mostly normal. Four mainly maxillary sinus lesions. EOS CRSwNP had the following characteristics: one most nasal discharge was mucous purulent; two bilateral sinus lesions were more common, mainly ethmoid sinus lesions; three the proportion of blood eosinophilic cells in peripheral blood was often increased. Ouroften accompanied by asthma, postoperative nasal polyps are prone to relapse, systemic steroid hormone is effective in the treatment of recurrent polyps. Conclusion: There are differences in clinical characteristics between eosinophilic and non-eosinophilic chronic sinusitis with nasal polyps. The ratio of eosinophils in peripheral blood, preoperative endoscopy and CT evaluation are helpful for the classification of chronic sinusitis with nasal polyps.
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Key words:
- rhinosinusitis /
- nasal polyps /
- eosinophil
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[1] CHO S W, KIM D W, KIM J W, et al.Classification of chronic rhinosinusitis according to a nasal polyp and tissue eosinophilia:limitation of current classification system for Asian population[J].Asia Pacific Allergy, 2017, 7:121-130.
[2] CAO P P, LI H B, WANG B F, et al.Distinct immunopathologic characteristics of various types of chronic rhinosinusitis in adult Chinese[J].J Allergy Clin Immunol, 2009, 124:478-484.
[3] KIM D, JIN H R, EUN K M, et al.Non-Eosinophilic Nasal Polyps Shows Increased Epithelial Proliferation and Localized Disease Pattern in the Early Stage[J].PLoS One, 2015, 10:e139945.
[4] KATO A.Immunopathology of chronic rhinosinusitis.[J].Allergol Int Offic J, 2015, 64:121-130.
[5] LOU H, MENG Y, PIAO Y, et al.Predictive significance of tissue eosinophilia for nasal polyp recurrence in the Chinese population[J].Am J Rhinol Allergy, 2015, 29:350-355.
[6] WANG X, ZHANG N, BO M M, et al.Diversity of TH cytokine profiles in patients with chronic rhinosinusitis:A multicenter study in Europe, Asia, and Oceania[J].J Allergy Clin Immunol, 2016, 138:1344-1353.
[7] PAYNE S C, EARLY S B, HUYETT P, et al.Evidence for distinct histologic profile of nasal polyps with and without eosinophilia[J].Laryngoscope, 2011, 121:2262-2267.
[8] YASUNORI S, JUNICHI I, MASANORI K, et al.New clinical diagnostic criteria for eosinophilic chronic rhinosinusitis[J].Auris Nasus Larynx, 2011, 38:583-588.
[9] TOKUNAGA T, SAKASHITA M, HARUNA T, et al.Novel scoring system and algorithm for classifying chronic rhinosinusitis:the JESREC Study[J].Allergy, 2015, 70:995-1003.
[10] WANG ET, ZHENG Y, LIU P F, et al.Eosinophilic chronic rhinosinusitis in East Asians[J].World J Clin Cases, 2014, 2:873-82.
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