Ren Hengyi, Lin Jiafeng, He Zhen, Zhao Yongqiang, Chen Jianqiu
Department of Otolaryngology Head and Neck Surgery，the 960th Hospital of PLA，Jinan，250031，China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Mar;36(3):189-193. doi: 10.13201/j.issn.2096-7993.2022.03.007.
This study aimed to investigate whether nasal nitric oxide（nNO） could be used to identify the main clinical phenotypes of primary diffuse chronic sinusitis（CRS） and reflect the severity of sinus mucosal lesions. A total of 57 patients with primary diffuse CRS were included as the case group in this study. And the patients were divided into eosinophilic CRS（EosCRS） group and non-EosCRS group according to the percentage of eosinophils in peripheral blood. At the same time, 32 healthy volunteers were selected as the control group. According to whether there is nasal polyps under nasal endoscopy, the EosCRS group was classified into EosCRS with nasal polyps（EosCRSwNP） and EosCRS without nasal polyps（EosCRSsNP）. In the same way, the non-EosCRS group was assigned to non-EosCRS with nasal polyps（non-EosCRSwNP） and non-EosCRS without nasal polyps（non-EosCRSsNP）. The levels of nNO were detected by single nostril air extraction with 10 mL/s flow rate and soft palate closure. The severity of sinus lesions were evaluated by Lund-Mackay score. The difference of nNO levels were compared by the Rank sum test. The correlation between nNO levels and Lund-Mackay score was analyzed by Pearson correlation analysis. ①The levels of nNO in EosCRS group [315.00（88.00, 446.50） ×10⁻⁹] and non-EosCRS group [419.00（181.00, 469.00） ×10⁻⁹] were significantly lower than those in the control group [457.00（431.00, 493.75） ×10⁻⁹]（<0.01）. ②The levels of nNO in EosCRSwNP group [260.00（71.75, 391.50） ×10⁻⁹] were significantly lower than that in EosCRSsNP group [557.00（442.50, 619.75） ×10⁻⁹], and that in non-EosCRSwNP group [210.00（159.75, 434.25） ×10⁻⁹] were significantly lower than non-EosCRSsNP group [455.00（425.00, 481.00） ×10⁻⁹]（<0.05）. ③There was a medially negative correlation between the levels of nNO and the total score of Lund-Mackay score in the EosCRS group（=-0.567, <0.01）. The levels of nNO can be used to determine whether primary diffuse CRS is accompanied by nasal polyps and reflect the severity of nasal sinus mucosal lesions, instead of identifying the main clinical phenotypes of primary diffuse CRS.
本研究旨在探讨鼻一氧化氮（nNO）是否可用于识别原发性弥漫性慢性鼻窦炎（CRS）的主要临床表型并反映鼻窦黏膜病变的严重程度。本研究共纳入57例原发性弥漫性CRS患者作为病例组。根据外周血嗜酸性粒细胞百分比将患者分为嗜酸性粒细胞性CRS（EosCRS）组和非嗜酸性粒细胞性CRS组。同时，选取32名健康志愿者作为对照组。根据鼻内镜检查是否存在鼻息肉，将EosCRS组分为有鼻息肉的EosCRS（EosCRSwNP）和无鼻息肉的EosCRS（EosCRSsNP）。同样，将非EosCRS组分为有鼻息肉的非EosCRS（非EosCRSwNP）和无鼻息肉的非EosCRS（非EosCRSsNP）。采用流速为10 mL/s的单鼻孔抽气法并封闭软腭检测nNO水平。采用Lund-Mackay评分评估鼻窦病变的严重程度。采用秩和检验比较nNO水平的差异。采用Pearson相关分析分析nNO水平与Lund-Mackay评分的相关性。①EosCRS组[315.00（88.00，446.50）×10⁻⁹]和非EosCRS组[419.00（181.00，469.00）×10⁻⁹]的nNO水平显著低于对照组[457.00（431.00，493.75）×10⁻⁹]（<0.01）。②EosCRSwNP组[260.00（71.75，391.50）×10⁻⁹]的nNO水平显著低于EosCRSsNP组[557.00（442.50，619.75）×10⁻⁹]，非EosCRSwNP组[210.00（159.75，434.25）×10⁻⁹]的nNO水平显著低于非EosCRSsNP组[455.00（425.00，481.00）×10⁻⁹]（<0.05）。③EosCRS组中nNO水平与Lund-Mackay评分总分呈中度负相关（=-0.567，<0.01）。nNO水平可用于判断原发性弥漫性CRS是否伴有鼻息肉并反映鼻窦黏膜病变的严重程度，而非识别原发性弥漫性CRS的主要临床表型。
