本文選題：慢性鼻-鼻竇炎 + IgE��； 參考：《廣州醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探討變應(yīng)性因素血清總IgE、血清特異性IgE、血清嗜酸性粒細(xì)胞、組織嗜酸性粒細(xì)胞與慢性鼻-鼻竇炎之間關(guān)系及血清特異性IgE與嗜酸性粒細(xì)胞關(guān)系。方法:選取2016年6月1日至2017年2月28日在我院耳鼻喉科住院的72例慢性鼻-鼻竇炎(CRS)的手術(shù)患者為實(shí)驗(yàn)組,選取同一時(shí)期在我院住院行鼻中隔矯正術(shù)的16例單純鼻中隔偏曲患者為對(duì)照組。將慢性鼻-鼻竇炎組分為慢性鼻-鼻竇炎伴鼻息肉組(CRSwNP)和慢性鼻-鼻竇炎不伴鼻息肉組(CRSsNP)。將慢性鼻-鼻竇炎血清特異性IgE(SIgE)陽性患者分為SIgE陽性組,血清特異性IgE(SIgE)陰性患者分為SIgE陰性組。根據(jù)慢性鼻-鼻竇炎患者組織嗜酸性粒細(xì)胞浸潤情況,分為嗜酸性粒細(xì)胞浸潤組(ECRS)、非嗜酸性粒細(xì)胞浸潤組(non-ECRS)。采用德國FOOKE ALLERG-O-LIQ-SYSTEM全自動(dòng)變態(tài)反應(yīng)體外定量檢測系統(tǒng)對(duì)患者血清總IgE、血清特異性IgE進(jìn)行檢測,對(duì)血清和組織嗜酸細(xì)胞進(jìn)行計(jì)數(shù),并對(duì)患者進(jìn)行病史詢問、視覺模擬量表(VAS)評(píng)分、Lund-Mackay CT系統(tǒng)評(píng)分、Lund—Kennedy內(nèi)鏡評(píng)分,探討變應(yīng)性因素(血清特異性IgE、血總IgE、血清嗜酸性粒細(xì)胞、組織嗜酸性粒細(xì)胞)與慢性鼻竇炎之間關(guān)系,血清特異性IgE、組織嗜酸性粒細(xì)胞對(duì)慢性鼻竇炎患者癥狀、體征病變程度評(píng)分的影響及血清特異性IgE(SIgE)與嗜酸性粒細(xì)胞、血清總IgE之間的關(guān)系。結(jié)果:1、血清特異性IgE、血清總IgE、血清嗜酸性粒細(xì)胞在CRSwNP組與對(duì)照組,CRSsNP組與對(duì)照組及CRSwNP組與CRSsNP組之間均無統(tǒng)計(jì)學(xué)差異。2、血清特異性IgE陽性組VAS評(píng)分平均為13.6,陰性組VAS評(píng)分平均為18.5,陽性組與陰性組VAS評(píng)分差異有統(tǒng)計(jì)學(xué)意義(t=-2.7,p=0.01)。血清特異性IgE陽性組CT評(píng)分平均為12.9,陰性組CT評(píng)分平均為12.1,差異無統(tǒng)計(jì)學(xué)意義(t=0.6,p=0.56)。血清特異性IgE陽性組內(nèi)鏡評(píng)分平均為7.6,陰性組內(nèi)鏡評(píng)分平均為7.4,兩組評(píng)分差異無統(tǒng)計(jì)學(xué)意義(t=0.3,p=0.8)。3、在嗜酸性粒浸潤組中,CRSwNP有11例,CRSsNP有2例;在非嗜酸性粒細(xì)胞浸潤組中,CRSwNP有18例,CRSsNP有19例,兩組差異有統(tǒng)計(jì)學(xué)意義(?2=5.1,p=0.02)。嗜酸性粒細(xì)胞浸潤組VAS評(píng)分平均為20.6,非嗜酸性粒細(xì)胞浸潤組VAS評(píng)分平均為15.4,兩者之間差異有統(tǒng)計(jì)學(xué)意義(t=2.1,p=0.04)。嗜酸性粒細(xì)胞浸潤組CT評(píng)分平均為14.5,非嗜酸性粒細(xì)胞浸潤組CT評(píng)分平均為10.7,兩者之間差異有統(tǒng)計(jì)學(xué)意義(t=2.4,p=0.02)。嗜酸性粒細(xì)胞浸潤組內(nèi)鏡評(píng)分平均為9.0,非嗜酸性粒細(xì)胞浸潤組內(nèi)鏡評(píng)分平均為6.8,兩者之間差異有統(tǒng)計(jì)學(xué)意義(t=2.5,p=0.02)。4、特異性IgE陽性組血嗜酸性粒計(jì)數(shù)平均為0.19,陰性組血嗜酸性粒細(xì)胞計(jì)數(shù)平均為0.18,兩組差異無統(tǒng)計(jì)學(xué)意義(t=0.2,p=0.8)。特異性IgE陽性組患者中組織嗜酸性粒細(xì)胞浸潤型有4例,非浸潤型有10例;特異性IgE陰性組患者中,組織嗜酸性粒細(xì)胞浸潤型有10例,非浸潤型有24例,兩組差異無統(tǒng)計(jì)血意義(?2=0.003,p=0.96)。特異性IgE陽性組血清總IgE濃度平均為226.3,陰性組血清總IgE濃度平均為87.5,兩組差有統(tǒng)計(jì)學(xué)意義(t=3.2,p=0.002)。結(jié)論:1、慢性鼻-鼻竇炎病因復(fù)雜,不能以IgE、嗜酸性粒細(xì)胞等單一因素作為判斷指標(biāo)。2、當(dāng)慢性鼻-鼻竇炎患者合并過敏狀態(tài)時(shí),癥狀和體征的病變程度不一定加重。3、慢性鼻-鼻竇炎組織嗜酸性粒細(xì)胞浸潤提示并發(fā)鼻息肉概率增加,且癥狀、體征病變程度加重,嗜酸性粒細(xì)胞浸潤程度與變態(tài)反應(yīng)無關(guān),可能存在非過敏性嗜酸性粒細(xì)胞浸潤型慢性鼻-鼻竇炎。
[Abstract]:Objective: To investigate the relationship between serum total IgE, serum specific IgE, serum eosinophil, tissue eosinophil and chronic rhinosinusitis and the relationship between serum specific IgE and eosinophil. Methods: 72 cases of chronic rhinosinusitis (CRS) in the Department of ENT of our hospital from June 1, 2016 to February 28, 2017 were selected. In the experimental group, 16 patients with nasal septum deviation in the same period were selected as the control group. The chronic rhinosinusitis group was divided into chronic rhinosinusitis with nasal polyp group (CRSwNP) and chronic rhinosinusitis without nasal polyp group (CRSsNP). The chronic rhinosinusitis serum specific IgE (SIgE) was used. The positive patients were divided into SIgE positive group, and the serum specific IgE (SIgE) negative patients were divided into SIgE negative group. According to the eosinophil infiltration in the patients with chronic rhinosinusitis, the eosinophil infiltration group (ECRS), the non eosinophilic granulocyte infiltration group (non-ECRS), and the German FOOKE ALLERG-O-LIQ-SYSTEM full automatic allergy body were used. The total IgE and serum specific IgE were detected by the external quantitative detection system. The serum and tissue eosinophils were counted, and the patient was asked for medical history, the visual analogue scale (VAS) score, the Lund-Mackay CT system score, and the Lund Kennedy endoscopy score, to explore the allergic factors (serum specific IgE, blood total IgE, serum eosinophilia). The relationship between granulocyte, eosinophil and chronic sinusitis, serum specific IgE, the influence of eosinophil on the symptoms of chronic sinusitis, the score of the degree of signs, the relationship between serum specific IgE (SIgE) and eosinophils, and the total IgE in serum. Results: 1, serum specific IgE, serum total IgE, serum There was no significant difference in eosinophil between the CRSwNP group and the control group. There was no statistical difference between the CRSsNP group and the control group and the CRSwNP group and the CRSsNP group. The average VAS score of the serum specific IgE positive group was 13.6, the mean VAS score in the negative group was 18.5. The difference of the VAS score between the positive group and the negative group was statistically significant (t=-2.7, p=0.01). The average score of the score was 12.9 and the negative group CT score was 12.1, the difference was not statistically significant (t=0.6, p=0.56). The average endoscopy score of the serum specific IgE positive group was 7.6, the average of the negative group was 7.4, and the two groups had no statistical significance (t=0.3, p=0.8).3. In the eosinophilic infiltration group, there were 11 CRSwNP and 2 cases in CRSsNP; in the non eosinophilic acid group, there were 2 cases in the non eosinophilic group. In the group of granulocyte infiltration, there were 18 cases of CRSwNP and 19 cases in CRSsNP. The difference between the two groups was statistically significant (2=5.1, p=0.02). The average VAS score of eosinophil infiltration group was 20.6 and the average VAS score of non eosinophil infiltration group was 15.4. The difference between the two groups was statistically significant (t=2.1, p=0.04). The average CT score of eosinophil infiltration group was average 14.5, the average CT score of non eosinophil infiltration group was 10.7, the difference between the two groups was statistically significant (t=2.4, p=0.02). The average endoscopy score of eosinophil infiltration group was 9, and the average endoscopy score of non eosinophilic granulocyte infiltration group was 6.8. There was a significant difference between the two groups (t=2.5, p=0.02).4, and the specific IgE positive group blood eosinophilia. The average particle count was 0.19, the mean blood eosinophil count in the negative group was 0.18, and the two groups were not statistically significant (t=0.2, p=0.8). There were 4 cases of tissue eosinophil infiltration in the patients with specific IgE positive group and 10 cases of non infiltrating type. In the specific IgE negative group, there were 10 cases of tissue eosinophil infiltration type and non infiltrating type. There were 24 cases, the two groups had no statistical significance (? 2=0.003, p=0.96). The average serum total IgE concentration in the specific IgE positive group was 226.3, the average serum IgE concentration in the negative group was 87.5, and the two groups were statistically significant (t=3.2, p=0.002). Conclusion: 1, the chronic rhinosinusitis is complicated and can not be judged by the single factor of IgE and eosinophil. Standard.2, when patients with chronic rhinosinusitis are allergic to allergic conditions, the degree of symptoms and signs does not necessarily aggravate.3. The eosinophil infiltration in chronic rhinosinusitis tissues suggests an increase in the probability of nasal polyps, and the symptoms, the severity of the signs, the degree of eosinophil infiltration and the allergic reaction, may be non allergic. Eosinophil infiltrating chronic rhinosinusitis.
【學(xué)位授予單位】：廣州醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R765

【參考文獻(xiàn)】

相關(guān)期刊論文 前5條

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本文編號(hào)：2013146