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慢性鼻-鼻窦炎患者鼻腔冲洗液和黏膜中呼吸道病毒的高检出率。

High rates of detection of respiratory viruses in the nasal washes and mucosae of patients with chronic rhinosinusitis.

机构信息

Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

出版信息

J Clin Microbiol. 2013 Mar;51(3):979-84. doi: 10.1128/JCM.02806-12. Epub 2013 Jan 16.

Abstract

Respiratory viral infections are often implicated as triggers of chronic rhinosinusitis (CRS) flare-ups. However, there is a paucity of respiratory viral surveillance studies in CRS patients, and such studies could elucidate the potential role of viruses in promoting symptoms and aggravating mucosal inflammation. Therefore, a prospective case-control study was conducted to determine the prevalence of respiratory viruses in CRS patients and non-CRS controls. Nasal lavage fluids and turbinate epithelial cells were collected prospectively from 111 CRS patients and 50 controls. Multiplex PCR was used to identify common respiratory viruses in both sample types and the infection rate was compared between groups. Respiratory viruses were detected in 50.5% of lavage samples and in 64.0% of scraping samples from CRS patients. The overall infection rate was significantly different in CRS patients and controls (odds ratio, 2.9 in lavage and 4.1 in scraping samples). Multiple viral infections were detected more frequently in lavage samples from CRS patients than those from controls (P < 0.01; odds ratio, 7.7). Rhinovirus was the most prevalent virus and the only virus with a significantly different infection rate in CRS patients and controls in both samples (odds ratio, 3.2 in lavage and 3.4 in scraping samples). This study detected a higher prevalence of respiratory viruses in CRS patients than controls, suggesting that there may be significant associations between inflammation of CRS and respiratory viruses, particularly rhinovirus. Further studies should investigate the exact role of highly prevalent respiratory viruses in CRS patients during symptomatic aggravation and ongoing mucosal inflammation.

摘要

呼吸道病毒感染常被认为是慢性鼻-鼻窦炎(CRS)发作的诱因。然而,CRS 患者的呼吸道病毒监测研究较少,此类研究可以阐明病毒在促进症状和加重黏膜炎症方面的潜在作用。因此,进行了一项前瞻性病例对照研究,以确定 CRS 患者和非 CRS 对照者中呼吸道病毒的流行情况。前瞻性收集了 111 例 CRS 患者和 50 例对照者的鼻灌洗液和鼻甲上皮细胞。采用多重 PCR 鉴定两种样本类型中的常见呼吸道病毒,并比较两组之间的感染率。在 50.5%的灌洗液样本和 64.0%的刮取样本中检测到呼吸道病毒。CRS 患者和对照组之间的总体感染率差异有统计学意义(OR 值,灌洗液中为 2.9,刮取样本中为 4.1)。CRS 患者灌洗液样本中检测到的多重病毒感染较对照组更为频繁(P < 0.01;OR 值,7.7)。鼻病毒是最常见的病毒,也是在两种样本中 CRS 患者和对照组之间感染率有显著差异的唯一病毒(OR 值,灌洗液中为 3.2,刮取样本中为 3.4)。本研究检测到 CRS 患者呼吸道病毒的流行率高于对照组,表明 CRS 炎症与呼吸道病毒之间可能存在显著关联,尤其是鼻病毒。进一步的研究应调查在症状加重和持续黏膜炎症期间,在 CRS 患者中高度流行的呼吸道病毒的确切作用。

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