慢性鼻-鼻窦炎钩突病理学改变与手术预后及CT诊断价值的相关性分析  

Correlations between pathologic characteristics of uncinate process and surgical outcomes and diagnostic value of CT in patients with chronic rhinosinusitis

作　　者：肖惠雯 徐唱[1] 方一[1] 张凌浩[1] 武鹏[1] 骆雅梅 李慧媚 杜瀚[1] 廖志苏[1] 

机构地区：[1]温州医科大学附属第一医院耳鼻咽喉科,温州325000

出　　处：《中国眼耳鼻喉科杂志》2017年第6期403-407,共5页Chinese Journal of Ophthalmology and Otorhinolaryngology

摘　　要：目的研究慢性鼻-鼻窦炎(CRS)患者钩突黏膜、骨质病理改变程度与患者主客观评分的相关性,并评估CT影像诊断价值。方法 107例慢性鼻-鼻窦炎患者,男性63例、女性44例;年龄22~59岁。取患者病变侧的钩突黏膜及骨质,行苏木素-伊红(HE)染色。依据黏膜间质炎性细胞的数目及Biedlingmaier分级方法分析黏膜、骨质病理改变程度,并研究二者的相关性。同时使用相关性分析研究钩突黏膜、骨质病理改变程度与视觉模拟评分(VAS)、鼻腔-鼻窦结局测试22条(SNOT-22条)、Lund-Kennedy评分的关系,以及钩突骨质病理分级与CT值、Lund-Mackay CT评分的关系。结果 CRS钩突黏膜炎性细胞浸润严重程度与钩突骨质病理分级存在明显的相关性。黏膜、骨质病理分级与VAS评分、SNOT-22评分、Lund-Kennedy评分呈正相关。钩突骨质病理分级与CT值、Lund-Mackay CT评分呈显著相关性。结论慢性鼻-鼻窦炎患者存在钩突黏膜、骨质的病理学改变,后者在一定程度上反映了疾病的严重程度及预后,同时CT测量在一定程度上可以客观评价骨质病理改变程度,为预后评价提供依据。Objective To investigate the correlation between the pathologic characteristics of uncinate process mucosa and bone and the subjective/objective scores in patients with chronic rhinosinusitis （CRS）, and to assess the diagnostic value of CT. Methods One hundred and seven patients with CRS （63 males and 44 females） participated in the study. They were aged between 22 and 59 years. The mucosae and bones of uncinate process were collected during operations. Hematoxylin-eosin （HE） staining was used for observing the pathological change. The number of inflammatory ceils in mucosal interstitial was used to observe the pathological grade of mucosa, and Biedlingmaier criterion was used for determining the pathological grade of bone. The correlations between the pathological grade of uncinate process＇ s mucosae and bones were analyzed. Meanwhile, the correlation between the pathological grade of the mucosae and bones, scores of visual analogue scale （VAS）, sino-nasal outcome test （SNOT-22）, and Lurid-Kennedy were investigated through correlation analysis. In the end, the correlations between pathologic changes of the bones and CT values, scores of Lund-Mackay CT were analyzed. Results The severity of inflammatory cell infiltration in mucosal interstitial of the patients with CRS was positively correlated with the pathologic changes of bone in CRS. Pathologic changes of mucosa and bone of uncinate process in CRS were positively correlated with scores of VAS, SNOT-22 and Lund-Kennedy. Positive cmTelations between the pathological grades of uncinate process bone and CT values, scores of Lund-Mackay CT were observed. Conclusions At a certain extent, the pathologic changes of uncinate process mucosa and bone present in patients with CRS might reflect the severity and prognosis of CRS. Furthermore, CT values of the uncinate process bone in CRS can be used to evaluate objectively the pathological degree of the uncinate process bone and the prognosis of CRS.

关 键 词：慢性鼻-鼻窦炎 钩突 病理改变 CT值 预后 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]