慢性鼻-鼻窦炎临床特征动态变化的初步研究  

The changes of clinical characteristics of chronic rhinosinusitis in recent 10 years

作　　者：王明婕[1] 孙鹏[2] 周兵[1] 李云川[1] 崔顺九[1] 黄谦[1] WANG Mingjie;SUN Peng;ZHOU Bing;LI Yunchuan;CUI Shunjiu;HUANG Qian(Department of Otolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,and Key Laboratory of Otolaryngology Head and Neck Surgery（Capital Medical University）,Ministry of Education,Beijing,100730,China;Department of Medical Records,Beijing Tongren Hospital,Capital Medical University)

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国家重点实验室(教育部),北京100730 [2]首都医科大学附属北京同仁医院病案科

出　　处：《临床耳鼻咽喉头颈外科杂志》2018年第19期1459-1463,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：首都医科大学科研培育基金(自然类)课题(No:PYZ2017110);首都医科大学附属北京同仁医院重点医学专项基金(No:trzdyxzy201702)

摘　　要：目的:探讨近10年慢性鼻-鼻窦炎(CRS)临床特征的变化,找寻CRS的发病规律和特点,为制定CRS的诊治方案提供思路。方法:分析2006年、2010年及2015年共1 955例明确诊断为CRS的患者的临床资料、合并哮喘发病率、合并AR发病率、外周血EOS升高比例、嗅觉功能异常比例及病理结果符合嗜酸粒细胞性鼻窦炎(ECRS)的患病比例。结果:纳入本研究的CRS患者共1 955例,其中2006年570例,2010年583例,2015年802例。3年中,主要患病人群均为30~59岁,患病年龄构成无明显变化;3年男女性别比分别为:1.95∶1,2.62∶1,2.16∶1。CRS合并哮喘的患者比例分别为:2006年3.51%(20例),2010年7.55%(44例),2015年17.58%(141例),明显呈逐渐上升趋势。CRS合并AR患者比例分别为:2006年10.35%(59例),2010年8.75%(51例),2015年14.09%(113例)。外周血EOS比值升高的患者比例分别为:2006年25.26%(144例),2010年36.88%(215例),2015年23.57%(189例)。病理结果中符合ECRS的患者比例,分别为:2006年24.04%,2010年21.10%,2015年55.49%,2015年ECRS患者比例较前明显升高,差异均有统计学意义(P<0.01)。嗅觉障碍患者比例分别为:2006年59.47%,2010年52.82%,2015年63.47%,2015年较前也升高,差异有统计学意义(P<0.05)。结论:近10年间CRS的临床特征有显著变化,其中,CRS合并哮喘患者的比例呈逐年上升趋势;ECRS患者也不断增加,较10年前有显著差异;嗅觉障碍患者呈增加趋势。为了提高CRS的治疗效果,需加强嗜酸粒细胞相关性上、下气道炎症的综合治疗。Objective：To analyze the dynamic changes of the clinical features of chronic rhinosinusitis in recent 10 years,so as to deeply understand the characteristics of chronic rhinosinusitis,and to provide new ideas for treatment of chronic rhinosinusitis.Method：This retrospective study was performed in patients who were diagnosed as chronic rhinosinusitis and enrolled.General information,clinical examination and pathological results were all collected,then patients＇ age,gender,the incidence of asthma and allergic rhinitis,peripheral eosinophil percentage,olfactory dysfunction and pathological results were statistically analyzed.Result：1 955 patients who were diagnosed as chronic rhinosinusitis（CRS）were enrolled in this study,including 570 patients in 2006,583 patients in 2010,and 802 patients in 2015.There were no obvious changes of age structure in these patients in three years.And there was no significant change in sex ratio as well.The proportions of patients with CRS concomitant with asthma were obviously increased in 10 years,which was 3.51% in 2006,7.55% in 2010,and 17.58% in 2015.The proportions of patients with allergic rhinitis were also increased,which was 10.35%in 2006,8.75% in 2010,and 14.09%in 2015.Peripheral eosinophil ratio was increased significantly in these patients after 2010.The proportions of ECRS in CRS were elevated in 2015 and almost doubled compared to 2006.Olfactory dysfunction increased significantly in 2015.Conclusion：In recent 10 years,there were obvious changes of clinical features of CRS.The proportion of patients with CRS concomitant with asthma showed a gradual increasing trend.ECRS significantly increased than it was 10 years ago.Olfactory dysfunction also increased significantly.In order to improve the therapeutic effect of CRS,it is necessary to strengthen the treatment of upper and lower airway inflammation related with eosinophil.

关 键 词：鼻窦炎 哮喘 嗜酸粒细胞 

分 类 号：R765.4[医药卫生—耳鼻咽喉科]