鼻息肉患者组织嗜酸粒细胞计数与改良鼻窦CT嗅区评分及嗅觉功能的关系

张丽川; 胡春华; 韩星雨; 孙智甫; 武大伟; 于玮; 姚淋尹; 孙敬武; 魏永祥

doi:10.13201/j.issn.1001-1781.2019.12.007

鼻息肉患者组织嗜酸粒细胞计数与改良鼻窦CT嗅区评分及嗅觉功能的关系

- 1. 首都医科大学附属北京安贞医院耳鼻咽喉头颈外科(北京, 100029);
- 2. 首都医科大学附属北京安贞医院病理科;
- 3. 中国科学技术大学附属第一医院(安徽省立医院)耳鼻咽喉头颈外科
基金项目:
国家自然科学基金项目(No:81670903)

北京市自然科学基金项目(No:7152057)

详细信息

通讯作者: 魏永祥,E-mail:weiyongxiang@vip.sina.com

中图分类号: R765.25

收稿日期: 2019-06-14

Correlation of tissue eosinophil count and modified CT olfactory cleft score and olfactory function in patients with nasal polyps

- 1 Department of Otolaryngology Head and Neck Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing, 100029, China;
- 2 Department of Pathology, Beijing An Zhen Hospital, Capital Medical University;
- 3 Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of USTC, An Hui Provincial Hospital

More Information

Corresponding author: WEI Yongxiang, E-mail: weiyongxiang@vip.sina.com

Received Date: 14 June 2019

摘要

摘要: 目的:探讨慢性鼻窦炎伴鼻息肉(CRSwNP)患者的组织嗜酸粒细胞计数与嗅觉功能的关系。方法:前瞻性选取59例CRSwNP患者,所有患者入选时至少近1个月未口服或局部用糖皮质激素类药物,均于门诊局部麻醉下取鼻息肉组织进行嗜酸粒细胞计数及百分率计算。将患者分为嗜酸性鼻息肉(ECRS)组和非嗜酸性鼻息肉(non-ECRS)组,2组之间进行基线资料比较;同时行Sniffin'Sticks嗅觉测试和嗅觉诱发电位检测、Lund-Mackay评分及改良鼻窦CT嗅区评分。对组织嗜酸粒细胞计数与Lund-Mackay评分、改良鼻窦CT嗅区评分、Sniffin'Sticks测试、嗅觉诱发电位潜伏期和波幅分别进行Spearman相关性分析。结果:59例CRSwNP患者中35例患者配合完成嗅觉诱发电位检测并获得可靠波形。ECRS组具有更高的嗅区CT评分、筛窦CT评分及血嗜酸粒细胞计数和百分率;ECRS组和non-ECRS组单、双侧气味测试阈值(T值)均存在明显区别(P=0.017)。组织嗜酸粒细胞计数与主观嗅觉障碍VAS评分无明显相关性(P>0.05),与Sniffin'Sticks嗅觉测试双侧T值存在负相关(r=-0.322,P=0.013),与前、后嗅裂区评分明显相关(r=0.431和0.415,P=0.001),与Lund-Mackay评分没有相关性,与嗅觉诱发电位N1波(r=0.504,P=0.001)和P2波(r=0.374,P=0.020)的潜伏期存在相关性;Sniffin'Sticks嗅觉测试单侧T值与嗅觉诱发电位单侧N1潜伏期存在负相关(r=-0.505,P=0.002)。结论:组织嗜酸粒细胞增多与CRSwNP嗅觉障碍密切相关,可通过改良鼻窦CT嗅区评分、Sniffin'Sticks嗅觉测试T值及嗅觉诱发电位的潜伏期反映出来。T值与嗅觉诱发电位N1波潜伏期负相关。
- 鼻息肉 /
- 嗜酸细胞 /
- 嗅觉 /
- 鼻窦CT /
- 嗅觉诱发电位
Abstract: Objective: To investigate the effect of tissue eosinophil count on olfactory function in patients with chronic sinusitis with nasal polyps(CRSwNP). Method: We prospectively selected 59 patients with CRSwNP. All the patients were not treated with oral or topical glucocorticoids for at least 1 month at the time of enrollment. All the nasal polyps were taken under local anesthesia in the outpatient department for eosinophil count and percentage calculation. The patients were divided into eosinophilic CRSwNP(ECRS group) and non-eosinophilic CRSwNP(non-ECRS group). Baseline data was compared between the two groups. Spearman correlation analysis was performed on tissue eosinophil count and Lund-Mackay score, modified olfactory cleft scores, Sniffin' Sticks olfactory test, olfactory evoked potential peak latency and amplitude respectively. Result: Thirty-five of 59 patients with CRSwNP completed olfactory evoked potential test, from whom we collected stable waveforms. The ECRS group had a higher olfactory cleft area CT score, ethmoid sinus CT score and blood eosinophil count and percentage; there was a significant difference between the ECRS group and the non-ECRS group in single and bilateral odor test threshold(T value)(P=0.017). There was no significant correlation between tissue eosinophil count and subjective olfactory VAS score(P>0.05). Tissue eosinophil count was related to the bilateral T value in Sniffin' Sticks olfactory test(r=-0.322, P=0.013), anterior and posterior olfactory cleft area scores(r=0.431 and 0.415, respectively, P=0.001) and olfactory evoked potential N1 latency(r=0.504, P=0.001) and P2 latency(r=0.374, P=0.020), but not related to Lund-Mackay scores. In addition, there was a significant correlation between the unilateral T score in Sniffin' Sticks test and the unilateral olfactory evoked potential N1 latency(r=-0.505, P=0.002).Conclusion: The increase of tissue eosinophilia was closely related to olfactory disfunctions in CRSwNP. It could be reflected by modified CT olfactory cleft score, Sniffin' Sticks olfactory test T value and oERP peak latency. In addition, T value was negatively consistent with latency of oERP N1 peak.
- nasal polyps /
- eosinophils /
- olfaction /
- sinus CT /
- olfactory event-related potential

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