Li X Y, Li J R, Zhang S J, Zhang Y Q, Qi Z W, Niu R F
Department of Otolaryngology, Affiliated Hospital of Chengde Medical College, Chengde, 067000, China.
Department of Otorhinolaryngology Head and Neck Surgery, Navy General Hospital.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Dec 5;31(23):1828-1832. doi: 10.13201/j.issn.1001-1781.2017.23.012.
To study the relationship between laryngopharyngeal reflux and chronic rhinosinusitis. A total of 46 patients were enrolled in this study including 25 cases with chronic rhinosinusitis with nasal polyps, 10 cases with chronic rhinosinusitis without nasal polyps and 11 cases underwent surgery due to abnormal nasal anatomy such as nasal septum deviation, bubble in the turbinate, etc. as control group. The expression of pepsin was detected using immunohistochemistry in three groups. The intensity of pepsin expression and CT score of sinus, blood eosinophils percentage, blood neutrophils percentage, blood basohils percentage, blood mononuclear percentage, blood lymphocytes percentage were analyzed. There were 8 strong positive cases (32%, 8/25), positive in 8 cases (32%, 8/25), 2 weakly positive cases (8%,2/25), 7 negative cases (28%, 7/25) in chronic rhinosinusitis with nasal polyps group. In the chronic rhinosinusitis without nasal polyps group, the expression of pepsin was strong positive in 4 cases (40%, 4/10), positive in 3 cases (30%, 3/10), weakly positive in 1 cases (10%, 1/10), negative in 2 cases (20%, 2/10). There were no strong positive expression in the control group, positive in 2 cases (18.2%, 2/11), weakly positive in 3 cases (27.3%, 3/11), negative in 6 cases (54.5%, 6/11), chronic rhinosinusitis with nasal polyps group and chronic rhinosinusitis without nasal polyps group higher than the control group (<0.05). There was no significant difference in pepsin expression between chronic rhinosinusitis with nasal polyps group and without group (=0.617). Spearman correlation analysis indicated that the intensity of pepsin was positively correlated with the score of Lund-Markay (=0.349,=0.017), there was no correlation with the percentage of various inflammatory cells. The positive expression intensity of pepsin in chronic rhinosinusitis without nasal polyps and chronic rhinosinusitis with nasal polyps is significantly higher than that in normal control group, suggested that there is a correlation between laryngopharyngeal reflux and chronic rhinosinusitis. Laryngopharyngeal reflux is positively correlated with the severity of nasal polyps. Chronic nasal inflammation caused by laryngopharyngeal reflux is not mediated by a certain kind of inflammatory cells.
研究喉咽反流与慢性鼻 - 鼻窦炎之间的关系。本研究共纳入46例患者，其中25例慢性鼻 - 鼻窦炎伴鼻息肉患者，10例慢性鼻 - 鼻窦炎不伴鼻息肉患者，11例因鼻中隔偏曲、鼻甲气泡等鼻腔解剖异常接受手术的患者作为对照组。采用免疫组织化学法检测三组中胃蛋白酶的表达。分析胃蛋白酶表达强度、鼻窦CT评分、血嗜酸性粒细胞百分比、血中性粒细胞百分比、血嗜碱性粒细胞百分比、血单核细胞百分比、血淋巴细胞百分比。慢性鼻 - 鼻窦炎伴鼻息肉组中，强阳性8例（32%，8/25），阳性8例（32%，8/25），弱阳性2例（8%，2/25），阴性7例（28%，7/25）。慢性鼻 - 鼻窦炎不伴鼻息肉组中，胃蛋白酶表达强阳性4例（40%，4/10），阳性3例（30%，3/10），弱阳性1例（10%，1/10），阴性2例（20%，2/10）。对照组无强阳性表达，阳性2例（18.2%，2/11），弱阳性3例（27.3%，3/11），阴性6例（54.5%，6/11），慢性鼻 - 鼻窦炎伴鼻息肉组和慢性鼻 - 鼻窦炎不伴鼻息肉组高于对照组（<0.05）。慢性鼻 - 鼻窦炎伴鼻息肉组与不伴鼻息肉组胃蛋白酶表达差异无统计学意义（=0.617）。Spearman相关分析表明，胃蛋白酶强度与Lund - Markay评分呈正相关（=0.349，=0.017），与各种炎症细胞百分比无相关性。慢性鼻 - 鼻窦炎不伴鼻息肉和慢性鼻 - 鼻窦炎伴鼻息肉中胃蛋白酶阳性表达强度显著高于正常对照组，提示喉咽反流与慢性鼻 - 鼻窦炎之间存在相关性。喉咽反流与鼻息肉严重程度呈正相关。喉咽反流引起的慢性鼻腔炎症不是由某种炎症细胞介导的。
