鼻黏膜不同炎症的临床表现及客观炎症指标的异同性研究OACSTPCD
Study on the clinical manifestations and objective inflammation indicators in patients with different nasal mucosal inflammation
目的 比较慢性鼻炎(CR)、慢性鼻窦炎伴鼻息肉(CRSwNP)和慢性鼻窦炎不伴鼻息肉(CRSsNP)患者在鼻部症状、生活质量评估和临床炎症指标表达方面异同.方法 研究共纳入2017年1月～2018年12月在北京同仁医院鼻科就诊的154例连续患者,年龄18～70岁,其中男性106例,女性48例.根据入选标准,纳入患者分为CR组、CRSsNP组和CRSwNP组.患者于就诊当天进行鼻内镜、鼻呼出NO(nasal exhaled nitric oxide,nNO)、皮肤点刺试验、鼻窦CT和血常规检查,并在医师指导下对自身鼻部症状进行视觉模拟量表(VAS)评分,填写鼻腔鼻窦结局测试22条(SNOT-22)问卷.共43例CR患者,58例CRSsNP患者及53例CRSwNP患者入选本研究.结果 CRSsNP组SNOT-22总分显著低于CR和CRSwNP组(30.0±19.4 vs.41.1±21.9,30.0±19.4 vs.40.9±18.7,P<0.05),CR组和CRSwNP组的SNOT-22总评分无统计学差异.CRSwNP组鼻部症状及鼻外症状平均得分最高;CRSsNP组得分较低;CR患者对睡眠的损害影响显著高于CRSsNP患者(9.9±6.2 vs.5.1±5.3,P<0.05),与CRSwNP组睡眠评分无显著差异(9.9±6.2 vs.7.1±5.7,P>0.05).当患者合并过敏原阳性时,CR、CRSsNP和CRSwNP之间症状评分及SNOT-22评分之间无统计学差异;当过敏原阴性时,无论症状评分还是SNOT-22评分,三者之间均表现出明显的统计学差异.结论 CR、CRSsNP和CRSwNP三种鼻黏膜炎症类型都对患者生活质量产生明显影响.就症状评分及生活质量评分而言,CR组和CRSwNP组相近且较CRSsNP组损害更明显.客观评价指标与症状和生活质量评分的变化趋势并不一致.
OBJECTIVE To test whether there are some differences among chronic rhinitis,chronic rhinosinusitis patients with nasal polyps(CRSsNP)and without nasal polyps(CRSsNP)in symptom severity,health-related quality-of-life impairment,and objective inflammatory factors.METHODS A total of 154 consecutive patients who had been treated at the Otolaryngology Department of Beijing Tongren Hospital from January 2017 to December 2018 were recruited in this study.The patients aged 18-70 years,with 106 males and 48 females.All patients performed endoscopic examination,nasal exhaled nitric oxide(nNO),skin prick test(SPT),sinus CT scan,complete blood count,and fulfilled the visual analogue scale(VAS)self-assessment of nasal symptoms and the SNOT-22 questionnaire under the guidance of the physician.According to the inclusion criteria,A total of 43 patients with CR,58 patients with CRSsNP and 53 patients with CRSwNP were enrolled in our study.RESULTS The total SNOT-22 score in CRSsNP group was significantly lower than that in CR and CRSwNP groups(30.0±19.4 vs.41.1±21.9,30.0±19.4 vs.40.9±18.7,P<0.05),and there was no significant difference between CR group and CRSwNP group.The average scores of nasal symptoms and extranasal symptoms in CRSwNP group were the highest;the scores in CRSsNP group were lower.The impact of CR patients on sleep damage was significantly higher than that in CRSsNP patients(9.9±6.2 vs.5.1±5.3,P<0.05),and there was no significant difference between CR group and CRSwNP group(9.9±6.2 vs.7.1±5.7,P>0.05).When patients suffered with positive SPT,there was no statistical difference in symptom scores and SNOT-22 scores between CR,CRSsNP,and CRSwNP;but with negative SPT,there was a significant statistical difference in both symptom scores and SNOT-22 scores among the three groups.CONCLUSION CR,CRSsNP and CRSwNP have a significant impact on quality of life,respectively.In terms of symptom scores and quality of life scores,the CR group and CRSwNP group are similar and the scores are higher than that of the CRSsNP group.However,the objective inflammation factors are not consistent with the subjective symptom scores and quality of life scores.
刘承耀;王向东;森巴;司马宇彤;刘仲燕;张罗
首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,耳鼻咽喉头颈外科学教育部重点实验室(首都医科大学),北京 100730||北京市耳鼻咽喉科研究所,鼻病研究北京市重点实验室,北京 100005首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,耳鼻咽喉头颈外科学教育部重点实验室(首都医科大学),北京 100730||北京市耳鼻咽喉科研究所,鼻病研究北京市重点实验室,北京 100005||首都医科大学附属北京同仁医院变态反应科,北京 100730
鼻炎鼻窦炎鼻息肉一氧化氮慢性鼻窦炎不伴鼻息肉慢性鼻窦炎伴鼻息肉鼻腔鼻窦结局测试22条视觉模拟量表
RhinitisSinusitisNasal PolypsNitric Oxidechronic rhinosinusitis without nasal polypschronic rhinosinusitis with nasal polypsSinonasal Outcome Test-22visual analogue scale
《中国耳鼻咽喉头颈外科》 2024 (006)
369-376 / 8
国家重点研发计划(2022YFC2504100);教育部长江学者创新团队(IRT13082);中国医学科学院医学与健康科技创新工程项目资助(2019-I2M-5-022);首都卫生发展科研专项重点攻关项目(2022-1-1091)
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