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目的探讨慢性鼻-鼻窦炎伴鼻息肉(CRSw NP)复发的相关影响因素。方法选取2011年2月至2014年3月就诊的CRSw NP患者206例,收集临床资料,鼻息肉组织病理学检查,所有患者手术治疗后进行随访,记录患者术后鼻息肉复发情况。结果 CRSw NP患者随访中,115例(55.8%)患者出现复发,91例(44.2%)患者未出现复发,复发组患者合并哮喘比例、外周血Eos比例、流涕评分、头/面疼痛评分、嗅觉损伤、Lund-Mackay评分和组织嗜酸性粒细胞(Eos)比例均高于未复发组,而外周血中性粒细胞(Neu)比例、组织Neu比例、组织淋巴细胞比例和组织浆细胞比例均低于未复发组,差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,组织嗜酸性粒细胞(Eos)比例是影响CRSw NP复发的独立危险因素(P<0.001);ROC曲线分析显示,组织Eos比例在预测CRSw NP复发时,曲线下面积0.948(95%CI:0.923~0.974),当组织Eos比例为18.9%时,灵敏度75.8%,特异度98.3%。结论组织Eos比例是影响CRSw NP复发的独立危险因素,当组织Eos比例为18.9%时,具有最佳的诊断价值。
Objective To investigate the related factors of recurrent nasal polyps (CRSw NP) in patients with chronic rhinosinusitis. Methods A total of 206 patients with CRSw NP were selected from February 2011 to March 2014. Clinical data and histopathological examination of nasal polyps were collected. All patients were followed up after operation and the recurrent nasal polyps were recorded. Results There were no recurrences in 115 (55.8%) patients and 91 (44.2%) patients in the CRSw NP group. There was no recurrence in the recurrent patients with recurrent asthma, Eos ratio in peripheral blood, nasal discharge, head / face pain score, Olfactory impairment, Lund-Mackay score and eosinophil (Eos) ratio were higher than those in the non-relapse group, while neutrophil (Neu) ratio, neutrophil ratio, lymphocyte proportion and proportion of plasma cells (P <0.05). Multivariate logistic regression analysis showed that the proportion of eosinophils (Eos) was an independent risk factor for the relapse of CRSw NP (P <0.001). ROC curve analysis showed that the area under the curve was 0.948 (95% CI: 0.923-0.974) when predicting the recurrence of CRSw NP. The sensitivity was 75.8% and the specificity was 98.3% when the tissue Eos ratio was 18.9%. Conclusions Tissue Eos ratio is an independent risk factor affecting the recurrence of CRSw NP. When the tissue Eos ratio is 18.9%, it has the best diagnostic value.