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目的:探讨变应性因素与慢性鼻-鼻窦炎(CRS)疾病严重程度之间的相关性以及其对CRS的病情发展和转归的影响。方法:101例CRS患者进行变应性因素血清相关指标检测:血清总IgE浓度、血清特异性变应原IgE半定量检测、血清嗜酸粒细胞阳离子蛋白(ECP)浓度及病史询问、Lund-Mackay CT系统评分。结果:CRS组血清总IgE浓度及血清ECP浓度均高于正常对照组(P<0.01);CRS组血清总IgE浓度增高发生率及血清ECP浓度增高发生率随着临床分型的加重而显著增加,并且在有既往相关手术史的患者中较无相关手术史患者中亦有显著增高(P<0.05);血清总IgE浓度及血清ECP浓度增高患者的平均Lund-Mackay CT评分较浓度正常患者CT评分有显著性增高。CRS组血清特异性变应原IgE半定量检测阳性率为67.32%,强阳性率27.72%;各分型之间特异性变应原强阳性率差异有统计学意义(P<0.05);有既往相关手术史的患者变应原强阳性率较无手术史患者的强阳性率显著性增高(P<0.05);变应原强阳性患者CT评分较阴性患者CT评分有显著性增高(P<0.05)。结论:变应性因素对CRS的病变程度有一定负面作用,是影响疾病严重度及手术预后的不良因素。
Objective: To investigate the correlation between allergic factors and the severity of chronic rhinosinusitis (CRS) and its impact on the progression and prognosis of CRS. Methods: 101 CRS patients were tested for serum related indices of allergic factors: serum total IgE concentration, semi-quantitative IgE of serum specific allergens, serum eosinophil cationic protein (ECP) concentration and history, Lund-Mackay CT system score. Results: Serum total IgE concentration and serum ECP concentration in CRS group were significantly higher than those in normal control group (P <0.01). The incidence of serum total IgE and serum ECP in CRS group increased significantly with the increase of clinical classification (P <0.05). The mean Lund-Mackay CT scores of serum total IgE and serum ECP were significantly higher than those of normal patients with CT Score significantly increased. In the CRS group, the positive rate of serum IgE was 67.32% and the strong positive rate was 27.72%. The strong positive rate of specific allergen between the three subtypes was statistically significant (P <0.05) The strong positive rate of allergen in patients with related surgery was significantly higher than that without operation (P <0.05). CT scores of patients with strong allergens were significantly higher than those of negative patients (P <0.05) ). Conclusion: Allergic factors have a negative effect on the severity of CRS and are the adverse factors affecting the severity of the disease and the prognosis of the surgery.