变应性因素对慢性鼻-鼻窦炎影响的研究  

Effect of allergic factors on chronic rhinosinusitis

作　　者：胡赟赟[1] 王士礼[1] 蔡昌枰[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院耳鼻咽喉科,上海200025

出　　处：《临床耳鼻咽喉头颈外科杂志》2008年第2期63-65,67,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨变应性因素与慢性鼻-鼻窦炎(CRS)疾病严重程度之间的相关性以及其对CRS的病情发展和转归的影响。方法:101例CRS患者进行变应性因素血清相关指标检测:血清总IgE浓度、血清特异性变应原IgE半定量检测、血清嗜酸粒细胞阳离子蛋白(ECP)浓度及病史询问、Lund-Mackay CT系统评分。结果:CRS组血清总IgE浓度及血清ECP浓度均高于正常对照组(P<0.01);CRS组血清总IgE浓度增高发生率及血清ECP浓度增高发生率随着临床分型的加重而显著增加,并且在有既往相关手术史的患者中较无相关手术史患者中亦有显著增高(P<0.05);血清总IgE浓度及血清ECP浓度增高患者的平均Lund-Mackay CT评分较浓度正常患者CT评分有显著性增高。CRS组血清特异性变应原IgE半定量检测阳性率为67.32%,强阳性率27.72%;各分型之间特异性变应原强阳性率差异有统计学意义(P<0.05);有既往相关手术史的患者变应原强阳性率较无手术史患者的强阳性率显著性增高(P<0.05);变应原强阳性患者CT评分较阴性患者CT评分有显著性增高(P<0.05)。结论:变应性因素对CRS的病变程度有一定负面作用,是影响疾病严重度及手术预后的不良因素。Objective：To explore the correlation between allergic factors and chronic rhinusinusitis, and discuss its effects on the development of illness. Method： One hundred and one cases were selected to detect allergic serum relative index： the concentration of serum TIgE, specific IgE semi-quantitative test, the concentration of serum ECP as well as inquiring medical record, Lund-Mackay CT system scoring. Result： The concentration of serum TIgE and serum ECP in CRS was higher than those in control （P〈0.01）. The increased proportion of serum TIgE and serum ECP was significantly different among clinical stages （P〈0. 05） and between the cases with and without prior sinus surgery （P〈0.05）. CT scores of the cases with serum TIgE and serum ECP increased were significantly higher than those without serum TIgE and serum ECP increased. The strong positive rate in CRS was significantly different among clinical stages （P〈0. 05）. The strong positive rate increased significantly in the cases with prior sinus surgery （P〈0.05）. CT scores in the cases with strong positive allergen were significantly higher than that in the cases without positive allergen （P〈0. 05）. Conclusion： These results suggest that allergic factors make some negative effect on the severity of CRS and are the index for the severity and worse prognosis of illness.

关 键 词：鼻-鼻窦炎 IGE 变应原 嗜酸粒细胞阳离子蛋白 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]