摘要目的 探讨慢性鼻-鼻窦炎伴鼻息肉( chronic rhinosinusitis with nasal polyps ,CRSwNP)患者外周血嗜酸粒细胞比例与内镜鼻窦手术疗效的相关性.方法 回顾性分析2011 年3 月至2016年3月因CRSwNP就诊于北京大学人民医院耳鼻咽喉头颈外科并行内镜鼻窦手术的72例患者,比较术前外周血嗜酸粒细胞比例升高与非升高的患者术后鼻部主观症状的改善情况及病情控制情况.使用t检验、卡方检验、Willcoxon秩和检验、Pearson相关分析对结果进行分析.结果 72例患者随访24～78个月,平均56个月.外周血嗜酸粒细胞比例升高组(n＝16)较非升高组(n＝56)术后视觉模拟量表(visual analogue scale,VAS)评分更高,差异有统计学意义(11.44 ±7.13比4.98 ±5.64, t＝3.726,P＜0.05);外周血嗜酸粒细胞比例升高组病情控制情况较非升高组差,差异有统计学意义(Z＝-1.979,P＜0.05). 72例患者外周血嗜酸粒细胞绝对值与组织中嗜酸粒细胞计数呈正相关(r＝0.429,P＜0.05).结论 外周血嗜酸粒细胞比例升高的CRSwNP患者,术后鼻部症状改善情况和病情控制程度相对较差.

abstractsObjective To investigate the effect of blood eosinophils on clinical effect of endoscopic sinus surgery for chronic rhinosinusitis with nasal polyps ( CRSwNP).Methods From March 2011 to March 2016, 72 cases with CRSwNP were treated by endoscopic sinus surgery in Department of Otorhinolaryngology Head and Neck Surgery , Peking University People′s Hospital.The clinical records were retrospectively reviewed , and the cases were divided into eosinophilia elevated and non-elevated group according to blood eosinophils , and nasal polyps were evaluated for histopathology eosinophil count. Statistical analysis was performed to compare two groups′pre-and post-operative symptoms of VAS score , sinus computed tomography ( CT) scans scores according to the Lund-Mackay system and the outcome of surgery.Both groups′factors that might have affected their outcome were analyzed by t-test, Chi square, Pearson Correlation Coefficient and Willcoxon rank sum test.Results Seventy two cases were followed up from 24 to 78 months.The average follow-up time was 56 months.The VAS score in the eosinophilia elevated group (n＝16) was higher than that in the non-elevated group(n＝56), and the difference was statistically significant (11.44 ±7.13 vs 4.98 ±5.64, t＝3.726, P＜0.05).The control of symptoms in the peripheral blood eosinophilia elevated group was less than that in the non-elevated group, and the difference was statistically significant (Z＝-1.979, P＜0.05).There was a positive correlation between eosinophil counts in peripheral blood and tissues of 72 cases (r＝0.429, P＜0.05).Conclusion There is a significant correlation between tissue and blood eosinophil counts , and eosinophilia group has poorer outcomes.