慢性鼻-鼻窦炎患者肺功能状况的研究  

Study on the pulmonary function of patients with chronic rhinosinusitis

作　　者：张燕妮 杨蓓蓓[2] 张思聪[1] 龚梁[1] 邹坚定[1] 陈建强[1] 胡博侠 ZHANG Yanni;YANG Beibei;ZHANG Sicong;GONG Liang;ZOU Jianding;CHEN Jianqiang;HU Boxia(Department of Otolaryngology,the People’s Hospital of Cixi City,Cixi 315300,China;Department of Otolaryngology,the Second Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China)

机构地区：[1]浙江省慈溪市人民医院耳鼻喉科,慈溪315300 [2]浙江大学医学院附属第二医院耳鼻喉科,杭州310003

出　　处：《中国眼耳鼻喉科杂志》2023年第4期289-292,297,共5页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：宁波市医学科技计划项目(2017a17)。

摘　　要：目的观察无明显下呼吸道疾病的慢性鼻-鼻窦炎患者的肺功能状况。方法将2016年1月—2019年12月浙江省慈溪市人民医院耳鼻喉科收治的78例慢性鼻-鼻窦炎患者作为研究组,154例健康体检者作为对照组,比较2组患者在通气功能(FEV1、FEV1%FVC)、小气道功能(MMEF、FEF75%、FEF50%)、换气功能(DLCO SB、DLCO/VA)方面的差异。采用鼻窦CT扫描Lund-Mackay评分表评估研究组患者的鼻窦炎严重程度,根据评分结果分成2个亚组,即鼻窦炎A组(评分≥10分)和鼻窦炎B组(评分<10分),将A组和B组分别和对照组进行比较。结果FEF50%(P<0.001)、MMEF(P=0.009)在研究组和对照组之间的差异有统计学意义。FEV1(P=0.019)、FEV1/FVC(P=0.020)、FEF50%(P<0.001)、MMEF(P=0.001)在鼻窦炎A组和对照组之间差异有统计学意义。所有指标在鼻窦炎B组和对照组之间差异均无统计学意义。结论没有明显下呼吸道疾病的鼻-鼻窦炎患者可能已经伴随着潜在的肺功能减退,表现为亚临床状态的通气气流受限,且与鼻窦病变的严重程度呈正相关。鼻-鼻窦炎对肺功能的影响从小气道病变开始,影响肺的通气功能,有引起肺阻塞性改变的倾向,对换气功能无明显影响。Objective To evaluate the effect of chronic rhinosinusitis(CRS)on pulmonary function in the patients without lower respiratory symptoms.Methods In a case-control study,78 CRS patients without lower respiratory symptoms and 154 healthy subjects as control group were enrolled.They underwent a pulmonary function test and were compared for pulmonary function parameters.Each patient in the study group was assessed for the severity of sinusitis based on the Lund-Mackay score from the sinus CT scan,and then they were divided into two groups based on the score:group A(≥10 scores)and group B(<10 cores).Results There were significant differences between study group and control group in FEF50%(P<0.001),MMEF(P=0.009);and between group A and control group in FEV1(P=0.019),FEV1/FVC(P=0.020),FEF50%(P<0.001)and MMEF(P=0.001).There was no significant difference between group B and the control group in all indicators.Conclusions CRS was associated with subclinical lower airway flow limitation.The effect of sinusitis on pulmonary function was positively correlated with the severity of sinus disease.CRS patients have small airway disease even in the absence of respiratory symptoms and CRS tends to cause obstructive pulmonary disease.

关 键 词：慢性鼻窦炎 肺功能 气流受阻 

分 类 号：R765.4[医药卫生—耳鼻咽喉科]