整体骨炎评分系统在慢性鼻-鼻窦炎中的临床应用及骨炎评估的意义  

Clinical implication of global osteitis score system and it＇s role in evaluation of osteitis of chronic rhinosinusitis

作　　者：成雷[1] 黄振校[1] 周兵[1] 黄谦[1] 王成硕[1] 崔顺九[1] 叶婷[1] 孙炎[1] 

机构地区：[1]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科学教育部重点实验室(首都医科大学),100730

出　　处：《中华耳鼻咽喉头颈外科杂志》2013年第2期119-122,共4页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：北京市卫生系统高层次人才专项经费资助（2009-3-36）

摘　　要：目的探讨整体骨炎评分系统（globalosteitisscoresystem，GOSS）在慢性鼻-鼻窦炎（chronicrhinosinusitis，CRS）中的临床应用及骨炎评估在临床中的意义。方法选择334例准备行内镜鼻窦手术（endoscopysinussurgery，ESS）的CRS患者，利用PHILIPSMxLiteView软件分析术前鼻窦CT，测量鼻窦骨质CT值、厚度、骨炎范围，并使用GOSS进行评分和分级，同时采用SPSS16．0软件分析GOSS与Lund—Mackay评分、Lund—Kennedy评分之间的相关性。结果CRS患者骨炎的发生率是53．9％（180／334例），其中2级以上有意义骨炎的发生率为33．8％（113／334例），骨炎平均（面±s）得分（7．51±7．27）分。上颌窦和前组筛窦的骨炎发生率最高，其中左侧前组筛窦为37．2％；右侧前组筛窦为32．8％；左侧上颌窦为46．1％；右侧上颌窦为42．2％。直线相关分析显示，GOSS评分与Lnnd—Mackay评分和Lund—Kennedy评分分别呈正相关趋势（r值分别为0．497、0．409，P值均〈0．001）。结论GOSS可以利用CT定义和评估CRS骨炎的严重程度，GOSS评分能够反映CRS的疾病严重程度。Objective To investigate the clinical application of global osteitis score system（GOSS） in patients with chronic rhinosinusitis（CRS）. Methods Three hundreds and thirty-four patients with CRS were enrolled prospectively in a large tertiary referral center. The paranasal sinus bone Hounsfield unit （Hu） , thickness, scope were measured by PHILIPS MxLiteView software. Nasal endoscopy Lund-Kennedy score was analyzed in all patients. Sinus CT scans of all patients were analyzed for Lund-Mackay score and for osteitis using the GOSS. Association between GOSS and Lund-Mackay, Lund-Kennedy was analyzed by SPSS 16. 0 software. Results The incidence of osteitis in patients with CRS was 53.9% （180/334）. The incidence of osteitis （more than grade 2） in patients with CRS was 33.8% （113/334）. Average GOSS score of osteitis was 7.51 ± 7.27. The highest incidences of osteitis were in the maxillary and anterior ethmoid sinuses. The left anterior ethmoid sinuses was 37.2%. The right anterior ethmoid sinuses was 32. 8%. The left maxillary sinuses was 46. 1%. The fight maxillary sinuses was 42.2%. GOSS score were significantly correlated with Lund-Mackay and Lund-Kennedy scores （r value were O. 497 and 0. 409 respeetively, all P 〈 0. 001 ）. Conclusion GOSS can define and evaluate the extent and the severity of osteitis in patients with CRS by using CT, and can also reflect the extent and the severity of CRS.

关 键 词：鼻窦炎 骨炎 体层摄影术 X线计算机 疾病严重程度指数 

分 类 号：R765[医药卫生—耳鼻咽喉科]