Meng Y F, Lou H F, Wang C S, Zhang L
Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otorhinolaryngology, Beijing 100005, China.
Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otorhinolaryngology, Beijing 100005, China; Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Feb 7;52(2):93-98. doi: 10.3760/cma.j.issn.1673-0860.2017.02.004.
To compare the value of sinonasal CT scan with other clinical parameters in the pre-diagnosis of eosinophilic chronic rhinosinusitis with nasal polyps (eCRSwNP). From January to May of 2016, One hundred and fifty consecutive CRSwNP patients (90 eCRSwNP and 60 non-eosinophilic CRSwNP) undergoing endoscopic functional sinus surgery in Beijing Tongren Hospital were recruited in this study. Preoperative CT scan, skin prick test (SPT) and oral fractional exhaled nitric oxide (FeNO) measurements were performed in each patient and full blood count with differential analysis was performed within 1 week before surgery. t test and X2 test were used to compare the age, gender, history of surgery, onset of asthma, history of allergy, CT scores' ratio for the ethmoid sinus and maxillary sinus (E/M ratio) and presence of osteoneogenesis of two groups. Mann-Whitney analysis was used to compare the total Lund-Mackay scores, FeNO and blood eosinophil counts of two groups. Logistic regression analysis and receiver operating characteristic (ROC) curve were used to assess the predictive value of clinical parameters. E/M ratio, FeNO, blood eosinophil percentage of eCRSwNP group was significantly higher than those of non-eosinophilic CRSwNP group [3.56±0.37 1.80±0.10, (34.4±18.1) μg/L (22.1±11.7) μg/L, 8.19%±1.50% 4.55%±5.60%; χ(2) value was 0.900; value was 0.994 and 0.900, respectively; all <0.05]. E/M ratio had the highest predictive value, with area under curve (AUC) value of 0.938. The cut-off point of 2.59 for E/M ratio demonstrated a sensitivity of 94.3% and a specificity of 89.6% for eCRSwNP. The E/M ratio is a more useful predictor in the diagnosis of eCRSwNP compared to other clinical parameters.
比较鼻窦CT扫描与其他临床参数在伴鼻息肉的嗜酸性粒细胞性慢性鼻-鼻窦炎(eCRSwNP)预诊断中的价值。2016年1月至5月,本研究纳入了在北京同仁医院接受内镜功能性鼻窦手术的150例连续性CRSwNP患者(90例eCRSwNP和60例非嗜酸性粒细胞性CRSwNP)。对每位患者进行术前CT扫描以及皮肤点刺试验(SPT)和口服呼出一氧化氮(FeNO)测量,并在手术前1周内进行全血细胞计数及分类分析。采用t检验和X2检验比较两组患者的年龄、性别、手术史、哮喘发作情况、过敏史、筛窦和上颌窦CT评分比值(E/M比值)以及骨生成情况。采用Mann-Whitney分析比较两组患者的Lund-Mackay总分、FeNO和血液嗜酸性粒细胞计数。采用Logistic回归分析和受试者工作特征(ROC)曲线评估临床参数的预测价值。eCRSwNP组的E/M比值、FeNO、血液嗜酸性粒细胞百分比显著高于非嗜酸性粒细胞性CRSwNP组[3.56±0.37比1.80±0.10,(34.4±18.1)μg/L比(22.1±11.7)μg/L,8.19%±?1.50%比4.55%±5.60%;χ(2)值为0.900;P值分别为0.994和0.900;均<0.05]。E/M比值具有最高的预测价值,曲线下面积(AUC)值为0.938。E/M比值的截断点为2.59,对eCRSwNP的敏感性为94.3%,特异性为89.6%。与其他临床参数相比,E/M比值在eCRSwNP的诊断中是更有用的预测指标。