慢性鼻-鼻窦炎患者细胞免疫功能与规范化鼻内镜手术疗效分析  

Analysis of the cellular immune function and efficacy of standardized nasal endoscopic surgery in patients with chronic rhinosinusitis

作　　者：刘骥[1] 林云[2] 邹映东[2] 杜娜 闵晓黎[2] 李亚波[2] LIU Ji;LIN Yun;ZOU Yingdong;DU Na;MIN Xiaoli;LI Yabo(Department of Otolaryngology,the First Hospital of Kunming,Kunming 650011,China)

机构地区：[1]云南省昆明市第一人民医院耳鼻喉科,昆明650011 [2]云南省中医医院检验科,昆明650021

出　　处：《中国眼耳鼻喉科杂志》2019年第2期92-94,99,共4页Chinese Journal of Ophthalmology and Otorhinolaryngology

摘　　要：目的通过分析慢性鼻-鼻窦炎(CRS)患者术前外周血免疫细胞水平与术后临床疗效之间的关系,探讨细胞免疫功能对CRS患者术后疗效的影响。方法选取昆明市第一人民医院耳鼻喉科2016～2017年收治的50例CRS患者作为研究对象,分为慢性鼻窦炎伴鼻息肉(CRSwNP)组和慢性鼻窦炎不伴鼻息肉(CRSsNP)组;以同期40例健康人群作为对照组,分析比较对照组和研究组术前外周血免疫细胞测定资料。将CRS患者根据术后临床疗效分为预后良好组和预后差组,比较2组间外周血免疫细胞水平。结果健康对照组、CRSw NP组和CRSs NP组的CD4^+T细胞分别为35.01±7.16、43.44±4.99和41.69±6.57,CD8^+T细胞分别为27.50±0.85、21.32±5.36和20.08±4.57,CD4^+/CD8^+比值分别为1.19(0.96,1.66)、2.07(1.63,2.34)和2.14(1.69,2.64),健康对照组与CRSw NP组、CRSs NP组间差异均有统计学意义(P值均<0.05),CRSw NP组与CRSs NP组的细胞免疫功能差异无统计学意义(P>0.05)。预后良好组与预后差组间CD3^+淋巴细胞分别为66.19±7.60和56.78±10.72,CD4^+T细胞分别为42.33±6.05和30.81±3.75,CD4^+/CD8^+比值分别为2.22±0.82和1.39±0.43,NK细胞分别为14.74±8.50和30.2±10.34,差异均有统计学意义(P值均<0.05)。结论 CRS患者存在免疫失衡现象,即CD4^+T细胞、CD4^+/CD8^+比值高于健康人群,CD8^+T细胞低于健康人群。采用规范化鼻内镜手术治疗,不同细胞免疫功能状态CRS患者术后康复情况不同,CD3^+淋巴细胞、CD4^+T细胞、CD4^+/CD8^+比值上升者术后疗效优于下降者。Objective To explore the effect of cellular immune function on the clinical efficacy in patients with chronic rhinosinusitis(CRS) by analyzing the relationship between preoperative immune cells in peripheral blood and the postoperative clinical efficacy. Methods A total of 50 cases of CRS were retrospectively collected from the Department of Otolaryngology of the First Hospital of Kunming from 2016 to 2017. They were divided into CRS with nasal polyps(CRSwNP) group and CRS without nasal polyps(CRSsNP) group. Forty healthy people who were admitted to the hospital in the same period were treated as the control group. The data of preoperative immune cells in peripheral blood of the control group and the case group were compared. Then the CRS patients were divided into good prognosis group and poor prognosis group and the levels of peripheral blood immune cells were compared. Results The CD4^+T cells in healthy control,CRSw NP and CRSs NP groups were 35.01±7.16,43.44±4.99 and 41.69±6.57,respectively;The CD8^+T cells were 27.50±0.85,21.32 ± 5.36 and 20.08± 4.57,respectively;The CD4^+/CD8^+ratios were 1.19(0.96,1.66),2.07(1.63,2.34) and 2.14(1.69,2.64),respectively. There were statistically significant differences among healthy control group,the CRSw NP group and the CRSs NP group(P<0.05). There was no statistically significant difference in cellular immune function between CRSw NP and CRSs NP group(P>0.05). The CD3^+lymphocytes were 66.19±7.60 and 56.78±10.72 in good-prognosis and poor-prognostic group,respectively;The CD4^+T cells were 42.33±6.05 and 30.81±3.75,respectively;The CD4^+/CD8^+ratios were 2.22±0.82 and 1.39±0.43,respectively;The NK cells were 14.74±8.50 and 30.2±10.34,respectively. There were statistically significant differences among them(P<0.05). Conclusions The immune function of CRS patients was imbalanced. The CD4^+T cells and CD4^+/CD8^+ratio was higher than healthy people,but CD8^+T cells was lower than them. With standardized nasal endoscopic surgery,there were differences in postop

关 键 词：慢性鼻-鼻窦炎 细胞免疫功能 鼻内镜手术 

分 类 号：R765.9[医药卫生—耳鼻咽喉科] R446.6[医药卫生—临床医学]