Evans F O, Sydnor J B, Moore W E, Moore G R, Manwaring J L, Brill A H, Jackson R T, Hanna S, Skaar J S, Holdeman L V, Fitz-Hugh S, Sande M A, Gwaltney J M
N Engl J Med. 1975 Oct 9;293(15):735-9. doi: 10.1056/NEJM197510092931502.
Twenty-four adults with clinical evidence of sinusitis were studied by 65 needle punctures of the maxillary antrum. Fourteen of 15 sinuses with normal transillumination and 19 of 26 that were dull had normal aspirates, whereas 24 of 24 that were opaque had abnormal aspirates (P less than 0.001). Marked mucosal thickening as determined radiologically (Water's view) was associated with abnormal aspirates whereas lesser mucosal thickening was not (P less than 0.001). In acute sinusitis, there was a strong correlation between high aspirate leukocyte counts (greater than 1000 per cubic millimeter) and infection as manifested by bacterial titers of greater than 10(5) per milliliter or the isolation of virus fungus (P greater than 0.001). Anterior-nasal-swab cultures correlated poorly with direct aspirate culters. Organisms frequently recovered from the sinus included Haemophilus influenzae, Strepto coccus pneumoniae, and anaerobic bacteria. Rhinovirus was recovered twice. Antibiotics were usedful in patients with acute sinusitis if the organism was sensitive in vitro (P less than 0.001).
对24例有鼻窦炎临床证据的成年人进行了65次上颌窦穿刺研究。15个透照正常的鼻窦中有14个以及26个透照 dull 的鼻窦中有19个吸出物正常，而24个不透光的鼻窦吸出物均异常（P<0.001）。放射学（华氏位）显示的明显黏膜增厚与异常吸出物相关，而较轻的黏膜增厚则无此关联（P<0.001）。在急性鼻窦炎中，吸出物白细胞计数高（每立方毫米大于1000）与感染之间存在强相关性，感染表现为细菌滴度大于每毫升10⁵或分离出病毒真菌（P>0.001）。前鼻拭子培养与直接吸出物培养相关性较差。鼻窦中经常分离出的微生物包括流感嗜血杆菌、肺炎链球菌和厌氧菌。两次分离出鼻病毒。如果病原体在体外敏感，抗生素对急性鼻窦炎患者有效（P<0.001）。
