影响慢性鼻-鼻窦炎骨炎的相关因素临床分析  

Clinical analysis of the correlation factors of chronic sinusitis osteitis

作　　者：成雷[1] 黄振校[2] 黄谦[2] 王成硕[2] 崔顺九[2] 林枫[2] 孙炎[2] 周兵[2] 

机构地区：[1]首都医科大学大兴医院耳鼻咽喉头颈外科,北京102600 [2]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科教育部耳鼻咽喉头颈科学重点实验室(首都医科大学)

出　　处：《中华耳鼻咽喉头颈外科杂志》2014年第3期205-209,共5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，卫生部2012年度卫生公益性行业科研专项经费项目

摘　　要：目的 利用整体骨炎评分系统,分析慢性鼻-鼻窦炎（chronic sinusitis,CRS）骨炎的严重程度与不同影响因素的相关性.方法 选择334例准备行内镜鼻窦手术的CRS伴或不伴鼻息肉（CRS with/without nasal polyps,CRSwNP/CRSsNP）的患者,通过PHILIPS MxLiteView软件分析术前鼻窦CT,利用整体骨炎评分系统进行评分和分级,分析CRS整体骨炎评分与性别、年龄、吸烟、CRS病程、哮喘、皮肤点刺试验（skin prick test,SPT）、阿司匹林哮喘（aspirin sensitive asthma,ASA）、鼻息肉、Lund-Mackay评分、Lund-Kennedy评分、鼻内镜手术次数之间的相关性,归纳总结出代表CRS骨炎严重程度的标志性因素.结果 CRS骨炎的严重程度与性别（P =0.542）、年龄（P=O.092）、吸烟（P=0.695）、SPT（P =0.182）之间没有相关性.多元线性回归分析显示,CRS骨炎严重程度与鼻息肉、ASA、哮喘无相关性（P值均＞0.05）,而与鼻内镜手术次数、Lund-Mackay评分、Lund-Kennedy评分、CRS病程之间具有相关性（r值分别为0.528、0.170、0.193、0.146,P值均＜0.01）.结论 骨炎是导致难治性鼻-鼻窦炎的一个重要原因,鼻内镜手术次数可以作为反映骨炎严重程度的一个重要标志.Objective To analyse the severity of chronic sinusitis osteitis and the correlation factors by global osteitis scoring scale （GOSS）.Methods Three hundreds and thirty-four patients with chronic rhinosinusitis with or without nasal polyps（CRSwNP/CRSsNP） were enrolled prospectively in a large tertiary referral center.Preoperative sinus CT was analysed by PHILIPS MxLiteView software.Using grading and classification of GOSS,the association between GOSS and gender,age,smoking,CRS course,asthma,skin prick test （SPT）,aspirin sensitive asthma （ASA）,nasal polyp,Lund-Mackay,Lund-Kennedy,the number of previous sinus surgeries was examined.Finally a marker factors of severity of CRS osteitis was concluded.Results There was no association between CRS osteitis and gender （P =0.542）,age （P =0.092）,smoking（P =0.695）,SPT（P =0.182）.Multiple liner regression analysis showed that there was no association between CRS osteitis and nasal polyps,ASA and asthma （all P 〉 0.05）.The severity of CRS osteitis was correlated with the number of previous sinus surgeries,Lund-Mackay scores,Lund-Kennedy scores,CRS course （r1 =0.528,r2 =0.170,r3 =0.193,r4 =0.146,respectively,all P 〈 0.01）.Conclusions Osteitis is an important reason of refractory chronic rhinosinusitis.The number of previous sinus surgeries can be used as an important marker for the severity of the osteitis.

关 键 词：鼻窦炎 骨炎 疾病严重程度指数 因素分析 统计学 再手术 

分 类 号：R765.4[医药卫生—耳鼻咽喉科]