嗜酸性粒细胞百分比和鼻内镜评分对慢性鼻窦炎伴鼻息肉并发哮喘患者复发的预测价值  

Predictive value of eosinophil percentage and nasal endoscopy score for recurrence in patients with chronic sinusitis with nasal polyps complicating asthma

作　　者：刘会芳 姚依松 王晶妍 王建伟[2,3] 杨玉娟 张宇 宋西成[2,3] LIU Huifang;YAO Yisong;WANG Jingyan;WANG Jianwei;YANG Yujuan;ZHANG Yu;SONG Xicheng(Second Clinical Medicine College,Binzhou Medical University,Yantai,Shandong,264003,China;Department of Otolaryngology Head and Neck Surgery,Yantai Yuhuangding Hospital,Qingdao University,Yantai,Shandong,264000,China;Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases,Yantai,Shandong,264000,China)

机构地区：[1]滨州医学院第二临床医学院,山东烟台264003 [2]青岛大学附属烟台毓璜顶医院耳鼻咽喉头颈外科,山东烟台264000 [3]山东省耳鼻咽喉科疾病临床研究中心,山东烟台264000

出　　处：《中国耳鼻咽喉头颈外科》2024年第11期727-731,共5页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：国家自然科学面上项目基金(82271146、82271147);山东省重大科技创新项目(2022CXGC020506);山东省博士后创新项目(SDCX-ZG-202400045)。

摘　　要：目的分析慢性鼻窦炎伴鼻息肉(CRSwNP)合并哮喘患者复发的危险因素,早期识别复发高风险患者,为CRSwNP合并哮喘患者的精准治疗与健康预后提供有利信息。方法回顾性分析2016年1月~2021年6月就诊的161例CRSwNP伴哮喘患者的人口学特征与相关临床资料,单因素分析采用χ2检验,基于Lasso的Cox回归分析与多因素Cox回归分析探究危险因素,并计算接受者操作特性曲线(ROC)曲线下面积(AUC)以判断模型性能。绘制相关影响因素的Kaplan-Meier(K-M)曲线。结果年龄[HR(95%CI):0.96(0.95~0.98),P<0.001]、性别[HR(95%CI):1.94(1.21~3.14),P=0.006]、组织嗜酸性粒细胞百分比(Eos%)[HR(95%CI):1.01(1.01~1.02),P=0.004]、内镜鼻息肉评分[HR(95%CI):0.86(0.78~0.96),P=0.005]与CRSwNP合并哮喘患者的复发高度相关。当组织Eos%>21.28%和内镜鼻息肉评分>4时,CRSwNP合并哮喘患者治疗后复发的可能性更高。结论年龄、性别、组织Eos%与内镜鼻息肉评分是CRSwNP合并哮喘患者病情复发的危险因素,其中Eos%>21.28%与内镜鼻息肉评分>4预示着CRSwNP合并哮喘患者的更高复发风险。OBJECTIVE To analyze the risk factors for relapse in patients with chronic rhinosinusitis with nasal polyps(CRSwNP)combined with asthm and provide favorable information for precise treatment and healthy prognosis of patients with CRSwNP combined with asthma.METHODS The clinical data of 161 patients with chronic rhinosinusitis with nasal polyps(CRSwNP)combined with asthm who underwent endoscopic surgery at the Department of Otolaryngology Head and Neck Surgery,Yantai Yuhuanding Hospital,affiliated to Qingdao University,from January 2016 to June 2021 were selected.Based on Lasso's Cox regression analysis and multifactorial Cox regression analysis,the associated risk factors were investigated,and the area under curve(AUC)was calculated to determine the performance of the model.Finally,the Kaplan-Meier(K-M)curves were plotted for the relevant influencing factors.RESULTS The Age[HR(95%CI):0.96(0.948-0.98),P<0.001],gender[HR(95%CI):1.94(1.21-3.14),P=0.006],tissue eosinophil percentage[HR(95%CI):1.01(1.01-1.02),P=0.004],and endoscopic nasal polyp score[HR(95%CI):0.86(0.78-0.96),P=0.005]were highly correlated with recurrence in patients with CRSwNP combined with asthma.Patients with CRSwNP combined with asthma had a higher likelihood of relapse after treatment when the tissue Eos%was>21.28%and the endoscopic nasal polyp score was>4.CONCLUSION The age,gender,tissue eosinophil percentage and endoscopic nasal polyp score are independent risk factors for disease recurrence in patients with CRSwNP combined with asthma.

关 键 词：鼻窦炎 鼻息肉 哮喘症 嗜酸细胞 内窥镜检查 鼻内镜评分 鼻息肉复发 

分 类 号：R562.25[医药卫生—呼吸系统] R765.41[医药卫生—内科学]