Kaldenbach T, Schäfer D, Gosepath J, Bittinger F, Klimek L, Mann W J
Hals-, Nasen-, Ohrenklinik und Poliklinik der Johannes Gutenberg-Universität Mainz.
Laryngorhinootologie. 1999 Aug;78(8):429-34. doi: 10.1055/s-2007-996903.
The development of nasal polyps might be influenced by different factors such as mucosal inflammation. Infiltration with eosinophils is a common finding, although in largely different quantitis.
We investigated 58 patients suffering from nasal polyps who were assigned for endonasal sinus surgery based on endoscopic and CT findings. Out of these patients, 52% have already had sinus surgery and had recurrent polyps. All patients were subjected to both, allergy testing and a functional in vitro test for aspirin intolerance. During surgery, tissue samples were gained and send for histological examination with special respect to eosinophil infiltration.
Eosinophil infiltration was observed in 66% of all patients. 37 patients (64%) exhibited aspirin intolerance only, four (7%) had a positive allergy test only, in 9 patients (15%) both, allergy and aspirin intolerance were diagnosed. Allergy and aspirin intolerance were accompanied by eosinophil tissue infiltration. Eosinophil infiltration was more common and more severe if allergy and aspirin intolerance were found together compared with the tissue eosinophilia in patients with either one entity.
This study confirms the importance of eosinophil infiltration in the pathogenesis of severe or recurrent nasal polyps based on allergy and aspirin intolerance. A coincidance of allergy and aspirin intolerance was found in an unexpected high number of patients.
鼻息肉的发生可能受多种因素影响，如黏膜炎症。嗜酸性粒细胞浸润是常见表现，尽管其数量差异很大。
我们调查了58例鼻息肉患者，这些患者根据内镜和CT检查结果被安排接受鼻内鼻窦手术。其中，52%的患者曾接受过鼻窦手术且息肉复发。所有患者均接受了过敏测试和阿司匹林不耐受的功能性体外测试。手术过程中获取组织样本并送检进行组织学检查，特别关注嗜酸性粒细胞浸润情况。
66%的患者观察到嗜酸性粒细胞浸润。37例患者（64%）仅表现出阿司匹林不耐受，4例（7%）仅过敏测试呈阳性，9例（15%）同时诊断出过敏和阿司匹林不耐受。过敏和阿司匹林不耐受均伴有嗜酸性粒细胞组织浸润。与仅患有其中一种疾病的患者相比，同时发现过敏和阿司匹林不耐受时，嗜酸性粒细胞浸润更常见且更严重。
本研究证实了嗜酸性粒细胞浸润在基于过敏和阿司匹林不耐受的严重或复发性鼻息肉发病机制中的重要性。意外发现大量患者同时存在过敏和阿司匹林不耐受。
