黏膜嗜酸性粒细胞增多与鼻息肉复发——慢性鼻-鼻窦炎的新分类。
Mucosal eosinophilia and recurrence of nasal polyps - new classification of chronic rhinosinusitis.
机构信息
Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan.
出版信息
Rhinology. 2011 Oct;49(4):392-6. doi: 10.4193/Rhino10.261.
BACKGROUND
Eosinophils and nasal polyps are believed to affect the surgical outcome of chronic rhinosinusitis (CRS). CRS is classified based on the presence of nasal polyps in western countries. The majority of patients with CRS with nasal polyps (CRS with NP) are characterized by predominantly eosinophilic inflammation. However, Asian patients with CRS with NP show characteristics indicative of neutrophilic inflammation. Therefore, are eosinophils or nasal polyps more important for the classification of CRS?
METHODS
A prospective cohort study conducted from April 2007 to March 2008 classified patients with CRS based on the presence of nasal polyps and mucosal eosinophilia. The recurrence rate of nasal polyps was compared between the groups. Recurrence rate was analysed as a time-dependent variable by the Kaplan-Meier method.
RESULTS
Eosinophilic inflammation was found in 59.6% of patients with CRS with NP. Patients with mucosal eosinophilia had higher polyp recurrence rate than patients without mucosal eosinophilia, whereas patients with nasal polyps did not have higher polyp recurrence rate than patients without nasal polyps.
CONCLUSIONS
Presence of mucosal eosinophilia is a more important factor than nasal polyps for classifying CRS in terms of the surgical outcome.
背景
嗜酸性粒细胞和鼻息肉被认为会影响慢性鼻-鼻窦炎（CRS）的手术结果。西方国家基于鼻息肉的存在对 CRS 进行分类。大多数伴有鼻息肉的 CRS（伴有 NP 的 CRS）患者以嗜酸性粒细胞炎症为主。然而，伴有 NP 的 CRS 的亚洲患者表现出中性粒细胞炎症的特征。那么，嗜酸性粒细胞还是鼻息肉对 CRS 的分类更重要？
方法
一项前瞻性队列研究于 2007 年 4 月至 2008 年 3 月进行，根据鼻息肉和黏膜嗜酸性粒细胞的存在对 CRS 患者进行分类。比较了两组患者鼻息肉的复发率。采用 Kaplan-Meier 方法对复发率进行时间依赖性变量分析。
结果
伴有 NP 的 CRS 患者中，嗜酸性粒细胞炎症占 59.6%。有黏膜嗜酸性粒细胞的患者比没有黏膜嗜酸性粒细胞的患者有更高的息肉复发率，而有鼻息肉的患者并不比没有鼻息肉的患者有更高的息肉复发率。
结论
在手术结果方面，黏膜嗜酸性粒细胞的存在比鼻息肉更能作为分类 CRS 的重要因素。
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