Suzuki M, Suko T, Sakamoto N, Mogi G
Department of Otolaryngology, Oita Medical University.
Nihon Jibiinkoka Gakkai Kaiho. 1998 Jun;101(6):821-8. doi: 10.3950/jibiinkoka.101.6_821.
Plain paranasal sinus radiographs including occipitofrontal and occipitomental views often show abnormal shadows in patients with allergic rhinitis. For that reason, the relationship between chronic sinusitis and allergy has been discussed for many years. Type I allergy is thought to be involved in the sinusitis which is called allergic sinusitis. However, there is not enough information pertaining to this disorder. In order to determine the clinical feature and the characteristics of paranasal sinus effusion in allergic sinusitis, we investigated the differences between 20 patients with allergic sinusitis and 20 with non-allergic chronic sinusitis used as controls. Clinical symptoms (nasal discharge, nasal obstruction, headache, postnasal discharge) and anterior rhinoscopic findings (nasal discharge, nasal edema), clinical examinations (type of x ray maxillary sinus shadow, bacteriology of nasal discharge), and pathological features of the paranasal sinus effusion were examined and compared in the two kind of sinusitis. Pathological findings of the effusion sampled from 14 patients with allergic sinusitis and 15 with non-allergic sinusitis included the number of eosinophils, activated eosinophils and neutrophils, concentrations of interleukin (IL)-1 beta, IL-4, IL-5, IL-8, and concentrations of leukotriene C4/D4/E4 and prostaglandin E2. The incidence and degree of postnasal discharge as a symptom and a nasal finding were lower in allergic sinusitis patients than in the controls. Microorganisms were detected less frequently in the allergic group. The number of eosinophils, activated eosinophils and neutrophils was higher in the paranasal sinus effusion of the patients with allergic sinusitis. The concentrations (ng/mg of protein) of IL-1 beta and IL-8 showed no difference between the two groups, but IL-4, and IL-5 were more prevalent per mg of protein in the effusion of allergic sinusitis patients. These findings suggest that the clinical features of allergic sinusitis include a low incidence and degree of postnasal discharge and a low rate of detection of bacteria, and that the sinus effusion is characterized by the presence of more eosinophils, activated eosinophils, and IL-5 than in those of chronic sinusitis.
包括枕额位和枕颏位在内的鼻窦平片，在变应性鼻炎患者中常显示异常阴影。因此，慢性鼻窦炎与变应性之间的关系已被讨论多年。I型变态反应被认为与称为变应性鼻窦炎的鼻窦炎有关。然而，关于这种疾病的信息并不充分。为了确定变应性鼻窦炎的临床特征和鼻窦积液的特点，我们调查了20例变应性鼻窦炎患者和20例用作对照的非变应性慢性鼻窦炎患者之间的差异。对两种鼻窦炎的临床症状（鼻分泌物、鼻塞、头痛、鼻后滴漏）和前鼻镜检查结果（鼻分泌物、鼻水肿）、临床检查（上颌窦X线阴影类型、鼻分泌物细菌学）以及鼻窦积液的病理特征进行了检查和比较。从14例变应性鼻窦炎患者和15例非变应性鼻窦炎患者采集的积液病理检查结果包括嗜酸性粒细胞、活化嗜酸性粒细胞和中性粒细胞的数量，白细胞介素（IL）-1β、IL-4、IL-5、IL-8的浓度，以及白三烯C4/D4/E4和前列腺素E2的浓度。作为一种症状和鼻检查结果，鼻后滴漏的发生率和程度在变应性鼻窦炎患者中低于对照组。变应性组中微生物的检出频率较低。变应性鼻窦炎患者鼻窦积液中嗜酸性粒细胞、活化嗜酸性粒细胞和中性粒细胞的数量较高。两组之间IL-1β和IL-8的浓度（ng/mg蛋白质）无差异，但变应性鼻窦炎患者积液中每毫克蛋白质中IL-4和IL-5更为普遍。这些发现表明，变应性鼻窦炎的临床特征包括鼻后滴漏的发生率和程度较低以及细菌检出率较低，并且鼻窦积液的特征是嗜酸性粒细胞、活化嗜酸性粒细胞和IL-5比慢性鼻窦炎患者更多。
