鼻内镜低温等离子消融术、鼻内镜动力切割术治疗SNIP对外周血炎性标志物影响及与复发的相关性  

Effects of nasal endoscopic low temperature plasma ablation and nasal dynamical systemassisted resection on peripheral blood inflammatory markers and their correlations with recurrence of sinonasal inverted papilloma

作　　者：李重[1] 李君梅 李宇[1] 王中亮 LI Zhong;LI Junmei;LI Yu;WANG Zhongliang(Department of Otolaryngology,Chengdu First People's Hospital,Chengdu 610095,China)

机构地区：[1]成都市第一人民医院耳鼻喉科,四川成都610095

出　　处：《中国医学物理学杂志》2025年第2期245-249,共5页Chinese Journal of Medical Physics

基　　金：四川省科技计划项目(2023YFS0324)。

摘　　要：目的:分析鼻内镜低温等离子消融术联合鼻内镜动力切割术治疗鼻腔鼻窦内翻性乳头状瘤(SINP)对外周血炎性标志物影响及与复发的相关性。方法:回顾性分析2021年5月~2023年5月成都市第一人民医院收治的60例SINP患者,均接受鼻内镜低温等离子消融术、鼻内镜动力切割术治疗。选取同时期体检者60例(设为对照组),对比对照组及SINP患者术前、术后各时间点的外周血炎性标志物水平变化,通过自制量表收集患者一般资料,记录复发情况,分析影响因素,并进一步分析外周血炎性因子水平与其相关性。结果:对照组及SINP患者术前、术后3d、术后1个月的血清肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、嗜酸性粒细胞阳离子蛋白(ECP)、嗜酸性粒细胞(EOS)水平相比有统计学意义(均P<0.001)。经单因素分析,TNF-α、CRP、IL-6、IL-8、核分裂象数、不典型增生、病程与SINP患者术后复发相关。经Spearman相关性分析可知:SINP患者术后复发与IL-6水平之间无相关性(P>0.05),与TNF-α、CRP、IL-8水平之间呈正相关性(P<0.05)。结论:鼻内镜低温等离子消融术联合鼻内镜动力切割术治疗SINP的效果显著,术后复发率低,且外周血炎性标志物与SINP的发生、发展关系密切,可能参与到疾病的复发中,并存在协同作用。Objective To analyze the effects of nasal endoscopic low temperature plasma ablation combined with nasal dynamical system-assisted resection on inflammatory markers in peripheral blood of sinonasal inverted papilloma(SINP)and their correlations with recurrence.Methods A retrospective analysis was performed on 60 SINP patients admitted to Chengdu First People's Hospital from May 2021 to May 2023,all of whom were treated with endoscopic low temperature plasma ablation and nasal dynamical system-assisted resection;and another 60 healthy persons who underwent physical examination in the same period were enrolled and set as control group.The changes of peripheral blood inflammatory markers before and at various time points after operation were compared between control group and SINP patients.General data of patients were collected by self-made scales.The recurrence was recorded,and its influence factors were analyzed for further exploring and the correlation between recurrence and levels of peripheral blood inflammatory factors.Results Statistically significant differences between control group and SINP group were found in serum tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),interleukin-6(IL-6),interleukin-8(IL-8),eosinophilic cationic protein(ECP)and eosinophilic granulocytes(EOS)before operation,3 days and 1 month after operation(all P<0.001).Univariate analysis identified that TNF-α,CRP,IL-6,IL-8,mitotic counts,atypical hyperplasia and course of disease were associated with postoperative recurrence in SINP patients.Spearman correlation analysis showed that the postoperative recurrence in SINP patients showed no correlation with IL-6 level(P>0.05),but positively correlated with TNF-α,CRP and IL-8 levels(P<0.05).Conclusion Nasal endoscopic low temperature plasma ablation combined with nasal dynamical system-assisted resection is effective for SINP,with a low postoperative recurrence rate.Moreover,peripheral blood inflammatory markers are closely related to the occurrence and development of SINP,which may

关 键 词：鼻内镜低温等离子消融术 鼻内镜动力切割术 鼻腔鼻窦内翻性乳头状瘤 复发 影响因素 炎性因子 

分 类 号：R765.2[医药卫生—耳鼻咽喉科] R739.62[医药卫生—临床医学]