侵袭性真菌性鼻窦炎发病因素的研究  

Study on the pathogenic factors of invasive fungal sinusitis

作　　者：张贵玲 刘明 时蕾 张志玉 时光刚 ZHANG Guiling;LIU Ming;SHI Lei;ZHANG Zhiyu;SHI Guanggang(Department of Otolaryngology Head and Neck Surgery,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan,Shandong,250000,China)

机构地区：[1]山东第一医科大学附属省立医院耳鼻咽喉头颈外科,山东济南250000

出　　处：《中国耳鼻咽喉头颈外科》2023年第8期500-505,共6页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：山东省自然科学基金面上项目(ER2020MH176)。

摘　　要：目的探寻侵袭性真菌性鼻窦炎(invasive fungal rhinosinusitis,IFRS)的发病原因,总结IFRS的临床特点,提高IFRS的诊断率和生存率,为IFRS治疗的临床选择提供新的视角。方法采用病例对照研究设计,将25例IFRS患者作为病例组,同时随机选取同期入院的50例慢性鼻窦炎伴鼻息肉患者及50例真菌球样鼻窦炎(fungal bulbous sinusitis,FBS)患者分别作为对照组1和对照组2。回顾性收集三组患者相应的临床信息及实验室检查数据进行分析,通过二元Logistic回归方程进行单因素和多因素分析来寻找IFRS相关的风险因素。结果IFRS组共25例,平均年龄64.1岁,合并糖尿病22例,高血压12例;CRSwNP组共50例,平均年龄48.5岁,合并糖尿病1例,高血压11例;FBS组共50例,平均年龄50.2岁,合并糖尿病5例,高血压12例,组间比较差异有统计学意义。IFRS组的血葡萄糖水平、糖化血清白蛋白水平、白细胞计数、中性粒细胞计数、中性粒细胞百分比、淋巴细胞百分比、C反应蛋白水平、D-二聚体值、尿糖阳性比均高于CRSwNP组和FBS组,淋巴细胞百分比均低于CRSwNP组和FBS组,差异有统计学意义。结论糖尿病、年龄、高血压、血白细胞计数、淋巴细胞百分比、中性粒细胞百分比、C反应蛋白水平、血葡萄糖水平、糖化血清白蛋白水平是IFRS发病的影响因素,糖尿病、白细胞计数是IFRS发病的独立影响因素。OBJECTIVE To explore the causes of invasive fungal rhinosinusitis(IFRS)and summarize the clinical characteristics of IFRS,improve the diagnosis rate and survival rate of IFRS,and provide a new perspective for the treatment of IFRS.METHODS A case-control study design was adopted.Twenty-five patients with IFRS were selected as the case group,and 50 patients with chronic sinusitis with nasal polyps(CRSwNP)and 50 patients with Fungal bulbous sinusitis(FBS)were randomly selected as control group 1 and control group 2,respectively.The clinical information and laboratory test data of three groups of patients were retrospectively collected and analyzed,and the risk factors related to IFRS were found by univariate and multivariate analysis with binary Logistic regression equation.RESULTS There were 25 cases in IFRS group,with an average age of 64.1 years,22 cases with diabetes and 12 cases with hypertension.There were 50 cases in CRSwNP group,with an average age of 48.5 years,1 case with diabetes and 11 cases with hypertension.There were 50 cases in FBS group,with an average age of 50.2 years,5 cases with diabetes and 12 cases with hypertension.The difference among the three groups was statistically significant.The blood glucose level,glycosylated serum albumin level,white blood cell count,neutrophil count,neutrophil percentage,lymphocyte percentage,C-reactive protein level,D-dimer value and urine glucose positive ratio in IFRS group were higher than those in CRSwNP group and FBS group,while the lymphocyte percentage was lower than those in CRSwNP group and FBS group,with statistical significance.CONCLUSION Diabetes,age,hypertension,white blood cell count,lymphocyte percentage,neutrophil percentage,C-reactive protein level,blood glucose level and glycosylated serum albumin level are the influencing factors of IFRS,while diabetes and white blood cell count are the independent influencing factors of IFRS.

关 键 词：真菌病 鼻窦炎 糖尿病 病例对照研究 病因学 

分 类 号：R765.41[医药卫生—耳鼻咽喉科]