摘要目的 探讨整体骨炎评分系统(global osteitis score system,GOSS)在慢性鼻-鼻窦炎(chronic rhinosinusitis,CRS)中的临床应用及骨炎评估在临床中的意义.方法 选择334例准备行内镜鼻窦手术(endoscopy sinus surgery,ESS)的CRS患者,利用PHILIPS MxLiteView软件分析术前鼻窦CT,测量鼻窦骨质CT值、厚度、骨炎范围,并使用GOSS进行评分和分级,同时采用SPSS 16.0软件分析GOSS与Lund-Mackay评分、Lund-Kennedy评分之间的相关性.结果 CRS患者骨炎的发生率是53.9％(180/334例),其中2级以上有意义骨炎的发生率为33.8％(113/334例),骨炎平均((x)±s)得分(7.51 ±7.27)分.上颌窦和前组筛窦的骨炎发生率最高,其中左侧前组筛窦为37.2％；右侧前组筛窦为32.8％；左侧上颌窦为46.1％；右侧上颌窦为42.2％.直线相关分析显示,GOSS评分与Lund-Mackay评分和Lund-Kennedy评分分别呈正相关趋势(r值分别为0.497、0.409,P值均＜0.001).结论 GOSS可以利用CT定义和评估CRS骨炎的严重程度,GOSS评分能够反映CRS的疾病严重程度.

abstractsObjective To investigate the clinical application of global osteitis score system(GOSS)in patients with chronic rhinosinusitis(CRS).Methods Three hundreds and thirty-four patients with CRS were enrolled prospectively in a large tertiary referral center.The paranasal sinus bone Hounsfield unit (Hu),thickness,scope were measured by PHILIPS MxLiteView software.Nasal endoscopy Lund-Kennedy score was analyzed in all patients.Sinus CT scans of all patients were analyzed for Lund-Mackay score and for osteitis using the GOSS.Association between GOSS and Lund-Mackay,Lund-Kennedy was analyzed by SPSS 16.0 software.Results The incidence of osteitis in patients with CRS was 53.9％(180/334).The incidence of osteitis(more than grade 2)in patients with CRS was 33.8％(113/334).Average GOSS score of osteitis was 7.51 ± 7.27.The highest incidences of osteitis were in the maxillary and anterior ethmoid sinuses.The left anterior ethmoid sinuses was 37.2％.The right anterior ethmoid sinuses was 32.8％.The left maxillary sinuses was 46.1％.The right maxillary sinuses was 42.2％.GOSS score were significantly correlated with Lund-Mackay and Lund-Kennedy scores(r value were 0.497 and 0.409 respectively,all P ＜ 0.001).Conclusion GOSS can define and evaluate the extent and the severity of osteitis in patients with CRS by using CT,and can also reflect the extent and the severity of CRS.