整体骨炎评分与慢性鼻-鼻窦炎预后的相关性分析  

Correlation between global osteitis scoring scale and prognosis in chronic rhinosinusitis

作　　者：林枫[1,2] 周兵[1] 成雷[3] 黄谦[1] 王明婕[1] 叶婷[1] 黄振校[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,北京100730 [2]首都儿科研究所附属儿童医院耳鼻咽喉科,北京100020 [3]首都医科大学大兴医院耳鼻咽喉科,北京102600

出　　处：《中国耳鼻咽喉颅底外科杂志》2015年第1期8-13,共6页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：卫生行业科研专项项目(201202005)

摘　　要：目的探讨整体骨炎评分(global osteitis scoring scale,GOSS)与慢性鼻-鼻窦炎(chronic rhinosinusitis,CRS)预后间的关系。方法选择30例准备行鼻内镜手术的CRS伴或不伴息肉的患者,通过Philips DICOM Viewer软件分析术前鼻窦CT,根据GOSS标准评分,以GOSS评分>5及GOSS评分≤5分成骨炎组和非骨炎组。收集病史(包括性别、年龄、CRS病程,吸烟、哮喘史、变应性鼻炎史、有无前期手术史、有无息肉、外周血EOS,评估VAS、SNOT-20、Lund-Kennedy、Lund-Mackay和GOSS评分,术后1年随访,再次评估术后各项评分,评判疗效,应用统计学方法分析骨炎组和非骨炎组间是否存在预后差异。结果骨炎组与非骨炎组两组术前VAS评分、SNOT-20评分、Lund-Kennedy评分及Lund-Mackay评分无明显差异;骨炎组较非骨炎组术后Lund-Kennedy评分、Lund-Mackay评分高且差异具有统计学意义(t值分别为2.871、2.241,P值均<0.05),两组患者术后VAS评分与SNOT-20评分比较无明显差异;骨炎组与非骨炎组各组内术后较术前VAS评分、SNOT-20评分、Lund-Kennedy评分、LundMackay评分降低且差异均具有统计学意义(P值均<0.05);GOSS评分手术前后无明显变化。骨炎组术后1年疗效比非骨炎组差(P<0.05)。术前GOSS评分与术后Lund-Kennedy评分和Lund-Mackay评分分别呈正相关趋势(r值分别为0.398、0.426,P值均<0.05)。结论 GOSS评分影响CRS预后的客观指标(Lund-Kennedy评分、Lund-Mackay评分),CRS骨炎患者较非骨炎患者术后预后差。GOSS评分宜作为术前骨炎评判的标准及预测CRS预后的指标。Objective To investigate the correlation between global osteitis scoring scale（ GOSS） and prognosis in patients with chronic rhinosinusitis（ CRS）.Methods A total of 30 adult patients with CRS were enrolled prospectively.Preoperative sinus CT was analyzed with Philips DICOM Viewer software.According to the scores of GOSS,the patients were divided in osteitis group（ GOSS 5） and non-osteitis group（ GOSS ≤5）.The medical history including patients＇ gender,age,CRS course,asthma,allergic rhinitis,operation history,nasal polyp was collected.Their peripheral eosinophil（ EOS） count,scores of VAS,SNOT-20,Lund-Kennedy,Lund-Mackay and GOSS were recorded.One year after operation,the scores of VAS,SNOT-20,Lund-Kennedy,Lund-Mackay and GOSS in all the patients were collected for evaluation of therapeutic effect.The difference of therapeutic effect between osteitis group and non-osteitis group was analyzed statistically.Results The differences of preoperative scores of VAS,SNOT-20,Lund-Kennedy and Lund-Mackay between the two groups were statistically insignificant（ all P〉0.05）.One year after operation,the scores of Lund-Kennedy and Lund-Mackay in osteitis group were higher than those in the non-osteitis group（ both P〉0.05） while the differences of VAS,SNOT-20 scores were insignificant.The scores of VAS,SNOT-20,Lund-Kennedy and Lund-Mackay decreased after endoscopic sinus surgery in both groups（ both P〉0.05）,but their differences between GOSS scores before and after surgery were insignificant.The prognosis was poor in the osteitis group.Preoperative GOSS scores were positively correlated with postoperative scores of Lund-Mackay and Lund-Kennedy（ r1 = 0.398,r2 = 0.426,both P〈0.05）.Conclusion GOSS can affect the objective indicators（ Lund-Mackay and Lund-Kennedy） of prognosis.The prognosis of CRS patients with osteitis was poor.GOSS can be used for judging the osteitis before endoscopic sinus surgery and to predict prognosis of CRS.

关 键 词：慢性鼻-鼻窦炎 骨炎 整体骨炎评分 预后 

分 类 号：R195.1[医药卫生—卫生统计学] R765.4[医药卫生—卫生事业管理]