术前临床特征对嗜酸性粒细胞型慢性鼻窦炎伴鼻息肉的预测价值
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新乡医学院第一附属医院耳鼻咽喉科

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河南省医学科技攻关计划项目(SBGJ2018056)


The predictive value of preoperative clinical features in eosinophilic chronic rhinosinusitis with nasal polyps
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the First Affiliated Hospital of Xinxiang Medical University

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    摘要:

    目的 探讨术前临床特征对嗜酸性粒细胞型慢性鼻窦炎伴鼻息肉(eosinophilic chronic rhinosinusitis with nasal polyps,ECRSwNP)的预测价值,并构建用于临床实践的诺模图。方法 选取2019年9月-2020年9月就诊于新乡医学院第一附属医院并行功能性鼻内镜手术治疗的慢性鼻窦炎伴鼻息肉(chronic rhinosinusitis with nasal polyps,CRSwNP)患者97例,根据术后病理结果嗜酸性粒细胞(eosinophils,EOS)浸润程度将其分为ECRSwNP组和非嗜酸性粒细胞型慢性鼻窦炎伴鼻息肉(nonesinophilc chronic rhinosinusitis with nasal polyps,nonECRSwNP)组,收集并比较两组患者的临床特征资料,采用单因素及多因素二元Logistic回归分析筛选对ECRSwNP有预测价值的术前特征资料,并构建用于临床实践的诺模图。采用SPSS26.0和R语言软件4.1.2对数据进行分析。结果 两组患者在是否合并哮喘史、外周血嗜酸性粒细胞百分比(eosinophil percentage,EOS%)、外周血嗜碱性粒细胞百分比(basophils percentage,Baso%)、日本难治性嗜酸性慢性鼻窦炎流行病学调查(Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis,JESREC)评分、上颌窦评分、前后组筛窦评分、CT总分、E/M[筛窦与上颌窦的Lund-Mackay评分比值]上差异具有统计学意义(P<0.05)。单因素及多因素二元Logistic回归分析并构建的诺模图显示,基于哮喘史、外周血EOS%、外周血Baso%、上颌窦评分、及E/M的诺模图对ECRSwNP具有较高的预测价值,协调性指数(C-index)值为0.909,95%可信区间(CI)为0.828~0.989。结论 基于哮喘史、外周血EOS%、外周血Baso%、上颌窦评分、及E/M的诺模图,对ECRSwNP具有较高的预测价值。

    Abstract:

    Objective To investigate the predictive value of preoperative clinical features for eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP), and to construct a nomogram for clinical practice.Methods 97 patients with chronic rhinosinusitis with nasal polyps ( CRSwNP ) who underwent functional endoscopic sinus surgery in the First Affiliated Hospital of Xinxiang Medical University from September 2019 to September 2020 were selected,and were divided into ECRSwNP group and nonesinophilc chronic rhinosinusitis with nasal polyps ( nonECRSwNP ) group,According to the postoperative pathological results of eosinophils ( EOS ) infiltration.The clinical characteristics of the two groups were collected and compared. The univariate and multivariate binary logistic regression analysis was used to screen the preoperative characteristics with predictive value for ECRSwNP, and the nomogram for clinical practice was constructed. SPSS26.0 and R language software 4.1.2 were used to analyze the data.Results There were significant differences in the history of asthma, peripheral blood EOS%, peripheral blood basophil percentage (Baso%), Japanese refractory eosinophilic chronic sinusitis epidemiological survey (JESREC) score, maxillary sinus score, ethmoid sinus score, CT total score and E/M[Lund-Mackay score ratio between ethmoid sinus and maxillary sinus] between the two groups (P < 0.05). The Novotels based on the history of asthma, peripheral blood EOS, peripheral blood Baso, maxillary sinus scores, and E/M have high predictive value for ECRSwNP, and the coordination index (C-index) value was 0.906, and the 95% confidence interval (CI) was 0.825–0.988.Conclusion Based on asthma history, EOS% in peripheral blood, Baso% in peripheral blood, maxillary sinus score and E/M nomogram has a high predictive value for ECRSwNP.

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  • 收稿日期:2022-04-19
  • 最后修改日期:2022-06-03
  • 录用日期:2022-06-07
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