糖代谢状态对慢性鼻窦炎患者术后嗅觉改善的影响及多因素分析  

Effect of glucose metabolism on postoperative olfactory improvement in patients with chronic sinusitis and multivariate analysis

作　　者：詹锡亨 谢佳合 陈添铭 赵华 詹智芳 卢雅熙 ZHAN Xiheng;XIE Jiahe;CHEN Tianming;ZHAO Hua;ZHAN Zhifang;LU Yaxi(Department of otolaryngology,Guangxi Liugang Medical Co.,Ltd.Hospital,545002,China)

机构地区：[1]广西柳钢医疗有限公司医院耳鼻咽喉科,柳州545002 [2]广西壮族自治区妇幼保健院,南宁

出　　处：《中国中西医结合耳鼻咽喉科杂志》2024年第4期261-265,共5页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的研究糖代谢状态对慢性鼻窦炎(CRS)患者术后嗅觉功能改善的影响。方法回顾性纳入2019年1月~2021年12月在我院耳鼻咽喉科行内窥镜鼻窦手术(ESS)的100例CRS患者,根据术后嗅觉障碍改善情况分为嗅觉改善组和嗅觉未改善组。检测患者糖代谢状态(包括正常血糖、糖尿病前期和糖尿病)及并分析其临床资料;采用单因素分析筛选影响嗅觉改善的因素并进行logistic多因素分析;对比两组患者的糖代谢状态分布情况。结果在100例CRS患者中,术后6个月嗅觉功能未改善22例(22.00%),术后嗅觉功能改善有78例(78.00%);经多因素Logistic分析结果显示,过敏性疾病、吸烟史、空腹血糖(FBG)、葡萄糖耐量试验血糖值(OGTT)、稳态模拟胰岛素抵抗指数(HOMA-IR)、嗜酸粒细胞百分比是CRS患者鼻内窥镜术ESS术后后嗅觉功能改善的独立影响因素(P<0.05);嗅觉功能未改善组中的IFG检出率占为45.45%,高于嗅觉功能改善组检出率15.38%,差异有统计学意义(P<0.05)。结论CRS患者术后嗅觉功能未改善组的IFG检出率较高。;有过敏性疾病、吸烟史、FBG、OGTT、HOMA-IR、嗜酸粒细胞百分比是影响CRS患者鼻内窥镜ESS术后嗅觉功能改善的独立影响因素。Objective To investigate the effect of glucose metabolism on postoperative improvement of olfactory function in patients with chronic rhinosinustitis(CRS).Methods A total of 100 patients with CRS who underwent endoscopic sinus surgery(ESS)in the Department of Otorhinolaryngology of our hospital from January 2019 to December 2021 were retrospectively included.According to the improvement of postoperative olfactory dysfunction,they were divided into olfactory improvement group and olfactory non-improvement group.The glucose metabolism status(including normal blood glucose,prediabetes and diabetes)and clinical data were analyzed.Univariate analysis was used to screen the factors affecting olfactory improvement and logistic multivariate analysis was performed.The distribution of glucose metabolism status was compared between the two groups.Results Among the 100 patients with CRS,the olfactory function was not improved in 22 cases(22.00%)6 months after operation,and the olfactory function was improved in 78 cases(78.00%).Multivariate logistic analysis showed that allergic diseases,smoking history,fasting blood glucose(FBG),oral glucose tolerance test(OGTT),homeostasis model assessment of insulin resistance(HOMA-IR)and eosinophil percentage were independent factors influencing the improvement of olfactory function in patients with CRS after endoscopic ESS sinus surgery(P<0.05).The detection rate of IFG in the non-improved olfactory function group was 45.45%higher than that in the improved olfactory function group(15.38%),and the difference was statistically significant(P<0.05).Conclusions The detection rate of IFG in CRS patients with unimproved olfactory function after surgery is higher.Allergic diseases,smoking history,FBG,OGTT,HOMA-IR,and percentage of eosinophils were independent influencing factors for the improvement of olfactory function in CRS patients after nasal ESSendoscopy.

关 键 词：糖代谢状态 慢性鼻窦炎 内窥镜鼻窦手术 嗅觉功能 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]