Clinical Characteristics Of Chronic Rhinosinusitis With Peripheral Blood Eosinophilie Increased

Objective: This study was designed to investigate the clinical characteristics of chronic rhinosinusitis patients with increased peripheral blood eosinophilia,including gender,age,subjective symptoms,preoperative and postoperative VAS scores,preoperative and postoperative endoscopic scores,preoperative CT scoring And E / M value,and to seek the clinical diagnosis of eosinophilic infiltrative chronic rhinosinusitis rapid classification of the basis for the nasal-sinus inflammatory disease classification and treatment to provide a theoretical basis.Methods: This article retrospectively analyzed the clinical data of 150 patients with chronic rhinosinusitis from October 2015 to October 2016 in our department.First,to understand the current history of patients admitted to hospital and past history,such as whether the nasal congestion,runny nose,headache,dizziness,loss of smell,memory and hearing loss,attention deficit and other major symptoms,and according to the severity of symptoms to patients with simulated vision Scale score.Patients with the following conditions are excluded: Previously diagnosed with fungal sinusitis,cystic fibrosis,in vivo parasite infection,ciliary involute syndrome patients;unilateral nasal disease patients;cold(especially fever)and oral cold medicine patients;Patients with severe heart,liver,kidney disease or psychosis;patients with autoimmune diseases or immunodeficiency diseases;respiratory allergic diseases(such as asthma);patients undergoing desensitization;recent use of angiotensin converting enzyme inhibitors,Monoamine oxidase inhibitors or beta-blockers;anti-allergic drugs such as glucocorticoids,leukotriene receptor antagonists,and antihistamines within a week.Second,to give blood routine examination,and according to the percentage of peripheral blood eosinophils is higher than our hospital normal upper limit of 5% as the standard,divided into two groups.Patients with paranasal sinus CT,nasal examination,endoscopic examination and improve the preoperative routine examination.Postoperative pathological examination of patients with diseased tissue,and observed high-power eosinophil count.Postoperative metering patients routinely rinse the nasal cavity and the use of nasal steroid hormones,monthly to the clinic at the end of nasal endoscopic dressing.The short-term efficacy evaluation was performed at 4 months postoperatively,and the simulated visual scale and nasal endoscopy were performed again.And the above results were analyzed statistically.details as follows:The details are as follows: Collected from October 2015 to October 2016 in Nanchang University Second Affiliated Hospital of Otolaryngology Head and Neck Surgery,clinical symptoms and sinus CT confirmed as chronic rhinosinusitis with or without nasal polyps complete collection of all the indicators of 150 cases patient.All the indicators were collected in 150 cases.The VAS score,the absolute value and percentage of eosinophils in peripheral blood,the Lund-Mackay score of nasal sinus CT,CT scores’ ratio for the ethmoid sinus and maxillary sinus(E/M ratio)and the Lund-Kennedy score were recorded.Endoscopic sinus surgery was performed on the patients,and the eosinophils were counted under high power microscope.After surgery to give anti-inflammatory,nasal irrigation and nasal steroids and other treatment,1-2 weeks after discharge for the first time to the outpatient endoscopy and cleaning surgery cavity,after every 1-2 months endoscopic examination and cleaning.The short-term efficacy evaluation was performed at 4 months postoperatively,and the simulated visual scale and nasal endoscopy were performed again.Results Statistical analysis and comparison of data were performed by SPSS17.0 statistical software.The statistical methods were analyzed by chi-square test(X2),Wilcoxon Mann-Whitney Test(Z)and Spearman rank correlation test.two independent samples t test(t),Logistic regression analysis and ROC curve.Results: In this group of patients with chronic rhinosinusitis in 150 cases,including 96 males and 54 females;peripheral blood eosinophil percentage increased in 44 cases,non-eosinophil percentage increased in 106 cases.The age distribution is between 14 and 70 years,with an average age of(40.0±4.06)years and a duration of between 3 months and 20 years.Univariate analysis of gender,age,major symptoms,preoperative VAS score,preoperative endoscopic score,preoperative CT score,E / M value,postoperative VAS score and endoscopic score and other factors,peripheral blood(P = 0.40),preoperative CT score(t = 4.678,p = 0.000),E / M(Z = 2.210,p = 0.027),postoperative endoscopic score(Z = 4.436,p = 0.000)and other non-eosinophilia group there was a difference,and the difference was statistically significant.Multivariate analysis of the above differences,peripheral blood eosinophils increased independent risk factors: age 30-59 years old: P = 0.000,OR = 10.508;preoperative sinus CT score P = 0.026,OR = 1.089;Preoperative right nasal sinus CT score P = 0.000,OR = 1.550 ROC analysis of b Eos percentages and counts was performed using the Eos count > 5% in the histopathology.The area under the curve was 0.694,p = 0.000,and the 95% confidence interval was b Eos percentage(0.589-0.799),b Eos count(0.593-0.795).Conclusion: The patient’s gender,the main symptoms,preoperative VAS score,preoperative endoscopic scores and peripheral blood eosinophils percentage was no significant correlation;Peripheral blood eosinophilia and age group were correlated,the patient preoperative CT score,endoscopic score was significantly increased;Peripheral blood eosinophils percentage and count can be used as an initial judge of the degree of eosinophil infiltration in patients with indicators.