Yang Fengjuan, Gan Weigang, Liu Feng, Xian Junming, Liu Shixi, Meng Juan
Department of Otolaryngology Head and Neck Surgery，West China School of Medicine，West China Hospital，Sichuan University，Chengdu，610041，China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020 Sep;34(9):799-804. doi: 10.13201/j.issn.2096-7993.2020.09.008.
To compare the nasal microbiota diversity between chronic rhinosinusitis with nasal polyp（CRSwNP） patients and controls, postoperative recurrent with non-recurrent CRSwNP, in order to provide new sight in CRSwNP treatment and prognosis. Forty-eight patients with CRSwNP were recruited as the experimental group, and 33 patients who underwent FESS and had no sinus inflammatory disease, including nasal septum deviation,inverted papilloma, pituitary adenomas, chronic dacryocystitis,or optical canal fractures, were recruited as control group. High-throughput sequencing of 16S rRNA was used to detect the bacterial communities in the nasal secretion which was collected from middle meatus during the operation. The difference of the microbiota diversity between CRSwNP and controls was compared. Patients with CRSwNP were followed up for 1 year after surgery to observe whether they had relapsed or not, and nasal secretions were collected again for bacterial microbiota detection. The difference between postoperative and preoperative microbiota of the non-recurrent CRSwNP were compared, and the difference between postoperative and preoperative microbiota of the recurrent CRSwNP were compared. One year after surgery, 12 cases of CRSwNP recurred（recurrent rate 25%）. The clinical history of the recurrent group was longer than that of the non-recurrent group（=0.018）, and the preoperative CT score（=0.001）, nasal polyp size score（=0.004） and the severity of postnasal drip symptom（=0.032） in the recurrent group were significantly higher than non-recurrent group. Comparing the preoperative nasal microbiota of CRSwNP with control, there was no significant difference about the richness, α diversity and β diversity, but the relative abundance of Actinobacteria（FDR =0.004） and Corynebacterium（FDR =0.005） of CRSwNP were significantly lower than that of control. After operation, the relative abundance of Actinobacteria（FDR ＝0.012） and Corynebacterium（FDR ＝0.003） increased, while the Bacteroidetes（FDR ＝0.040） decreased in the non-recurrent CRSwNP; However, there was no change in the nasal bacterial microbiota in the recurrent group. CRSwNP was associated with nasal bacterial dysbiosis, and the postoperative improvement of dysbiosis was correlated with the prognosis of CRSwNP.
为比较慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）患者与对照组之间、CRSwNP术后复发与未复发患者之间的鼻腔微生物群多样性，以便为CRSwNP的治疗和预后提供新的见解。招募48例CRSwNP患者作为实验组，招募33例接受功能性鼻内镜鼻窦手术（FESS）且无鼻窦炎性疾病（包括鼻中隔偏曲、内翻性乳头状瘤、垂体腺瘤、慢性泪囊炎或视神经管骨折）的患者作为对照组。采用16S rRNA高通量测序检测术中从鼻中道采集的鼻腔分泌物中的细菌群落。比较CRSwNP患者与对照组之间微生物群多样性的差异。对CRSwNP患者术后随访1年，观察其是否复发，并再次采集鼻腔分泌物进行细菌微生物群检测。比较未复发CRSwNP患者术后与术前微生物群的差异，以及复发CRSwNP患者术后与术前微生物群的差异。术后1年，12例CRSwNP复发（复发率25%）。复发组的临床病程长于未复发组（P =0.018），复发组术前CT评分（P =0.001）、鼻息肉大小评分（P =0.004）和鼻后滴漏症状严重程度（P =0.032）均显著高于未复发组。比较CRSwNP患者术前鼻腔微生物群与对照组，在丰富度、α多样性和β多样性方面无显著差异，但CRSwNP患者放线菌门（FDR =0.004）和棒状杆菌属（FDR =0.005）的相对丰度显著低于对照组。术后，未复发CRSwNP患者中放线菌门（FDR ＝0.012）和棒状杆菌属（FDR ＝0.003）的相对丰度增加，而拟杆菌门（FDR ＝0.040）减少；然而，复发组鼻腔细菌微生物群无变化。CRSwNP与鼻腔细菌生态失调有关，术后生态失调的改善与CRSwNP的预后相关。
