[1]邱志利,袁小东,胡春凤,等.鼻呼气一氧化碳监测联合免疫球蛋白E、嗜酸性粒细胞评估鼻窦炎鼻息肉手术疗效临床研究[J].陕西医学杂志,2024,(10):1356-1361.[doi:DOI:10.3969/j.issn.1000-7377.2024.10.013]
　QIU Zhili,YUAN Xiaodong,HU Chunfeng,et al.Application of nasal NO combined with IgE and EOS in evaluating curative effect of sinus surgery in rhinosinusitis with nasal polyps[J].,2024,(10):1356-1361.[doi:DOI:10.3969/j.issn.1000-7377.2024.10.013]
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鼻呼气一氧化碳监测联合免疫球蛋白E、嗜酸性粒细胞评估鼻窦炎鼻息肉手术疗效临床研究
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2024年10期
页码:
1356-1361
栏目:
临床研究
出版日期:
2024-10-05

文章信息/Info

Title:
Application of nasal NO combined with IgE and EOS in evaluating curative effect of sinus surgery in rhinosinusitis with nasal polyps
作者:
邱志利; 袁小东; 胡春凤; 熊傲雪
(重庆大学附属三峡医院耳鼻咽喉科,重庆 万州 404000)
Author(s):
QIU Zhili; YUAN Xiaodong; HU Chunfeng; XIONG Aoxue
(Department of Otolaryngology,Chongqing University Three Gorges Hospital,Wanzhou 404000,China)
关键词:
鼻呼气一氧化碳;  免疫球蛋白E;  嗜酸性粒细胞;  慢性鼻-鼻窦炎;  功能性鼻内镜鼻窦手术;  疗效
Keywords:
Nasal nitric oxide;  Immunoglobulin E;  Eosinophil;  Chronic rhinosinusitis;  Functional nasal endoscopic sinus surgery;  Curative effect
分类号:
R 765.4
DOI:
DOI:10.3969/j.issn.1000-7377.2024.10.013
文献标志码:
A
摘要:
目的:探讨鼻呼气一氧化碳(nNO)监测联合免疫球蛋白E(IgE)、嗜酸性粒细胞(EOS)在鼻窦炎鼻息肉手术疗效中的评估价值。方法:选取收治的慢性鼻-鼻窦炎(CRS)患者102例,根据是否伴有鼻息肉分为CRS伴鼻息肉(CRSwNP)组(n=57)和CRS不伴鼻息肉(CRSsNP)组(n=45),均行功能性鼻内镜鼻窦手术治疗。对比两组患者术前及术后nNO、IgE、EOS、鼻窦 CT(Lund-Mackay 评分法)、术腔黏膜形态(Lund-Kennedy)评分及视觉模拟评分(VAS)。评估CRSwNP患者术后12个月的疗效情况,Pearson相关性分析术后nNO、IgE、EOS与Lund-Kennedy、VAS评分的关系; 受试者工作曲线(ROC)分析术前nNO、IgE、EOS水平对患者疗效的预测价值。结果:术前CRSwNP组nNO低于CRSsNP组,IgE、EOS水平及Lund-Mackay、Lund-Kennedy、VAS评分高于CRSsNP组(均P<0.05)。术后CRSwNP组和CRSsNP组nNO、IgE、EOS水平及Lund-Kennedy、VAS评分的时间点比较差异有统计学意义(均P<0.05),但上述指标组间比较及交互作用比较差异无统计学意义(均P>0.05)。术后12个月,CRSwNP患者有效率为70.18%(40/57),无效率为29.82%(17/57)。术前、术后,有效组nNO水平均高于无效组,IgE、EOS水平及Lund-Kennedy、VAS评分低于无效组(均P<0.05)。术后Lund-Kennedy、VAS评分与nNO水平呈负相关,与IgE、EOS水平呈正相关(均P<0.05)。ROC结果显示,术前nNO、IgE、EOS及其联合检测预测CRSwNP患者术后疗效的曲线下面积(AUC)分别为0.743、0.778、0.746、0.824(均P<0.05)。结论:功能性鼻内镜鼻窦手术可有效治疗CRSwNP与CRSsNP。术前CRSwNP患者nNO水平降低,IgE、EOS水平升高,且均与Lund-Kennedy、VAS评分密切相关,临床可通过联合检测nNO、IgE、EOS早期对CRSwNP患者术后疗效进行预测。
Abstract:
Objective:To explore the evaluation value of nasal nitric oxide(nNO)combined with immunoglobulin E(IgE)and eosinophils(EOS)for curative effect of sinus surgery in rhinosinusitis with nasal polyps.Methods:A total of 102 patients with chronic rhinosinusitis(CRS)were retrospectively enrolled.According to presence or absence of nasal polyps,they were divided into CRS with nasal polyps(CRSwNP)group(57 cases)and CRS without nasal polyps(CRSsNP)group(45 cases).All patients underwent functional nasal endoscopic sinus surgery.The nNO,IgE,EOS,scores of sinus CT(Lund-Mackay),morphology of intraoperative mucosa(Lund-Kennedy)and VAS score were compared between the two groups before and after surgery.The curative effect in CRSwNP patients was evaluated at 12 months after surgery.The relationship between postoperative nNO,IgE,EOS and Lund-Kennedy,VAS scores was analyzed by Pearson correlation analysis.The predictive value of preoperative nNO,IgE and EOS for curative effect was analyzed by ROC curves.Results:Before surgery,nNO in CRSwNP group was lower than that in CRSsNP group,while levels of IgE and EOS,scores of Lund-Mackay,Lund-Kennedy and VAS were higher than those in CRSsNP group(all P<0.05).After surgery,there were significant differences in levels of nNO,IgE and EOS,scores of Lund-Kennedy and VAS at different time points in the two groups(all P<0.05),but there were no significant difference in terms of inter-group dimension and interaction dimension(all P>0.05).At 12 months after surgery,response rate and non-response rate in CRSwNP patients were 70.18%(40/57)and 29.82%(17/57),respectively.Before and after surgery,nNO level in effective group was higher than that in ineffective group,while levels of IgE and EOS,scores of Lund-Kennedy and VAS were lower than those in ineffective group(all P<0.05).After surgery,scores of Lund-Kennedy and VAS were negatively correlated with nNO level,while positively correlated with levels of IgE and EOS(all P<0.05).The results of ROC curves analysis showed that the AUC of preoperative nNO,IgE,EOS and combined detection(parallel mode)for predicting postoperative curative effect in patients with CRSwNP were 0.743,0.778,0.746 and 0.824,respectively(all P<0.05).Conclusion:Functional nasal endoscopic sinus surgery can effectively treat CRSwNP and CRSsNP.Before surgery,nNO level is decreased,while levels of IgE and EOS are increased in patients with CRSwNP,and the three indexes are closely related to scores of Lund-Kennedy and VAS.Clinically,early combined detection of nNO,IgE and EOS could predict postoperative curative effect in patients with CRSwNP.

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备注/Memo

备注/Memo:
基金项目:重庆市科卫联合医学科研项目(2020MSXM061); 重庆市万州区科卫联合医学科研项目(WZSTC-KW2022034)
更新日期/Last Update: 2024-10-08