山西医科大学第二医院 耳鼻咽喉头颈外科 山西省气道炎性疾病神经免疫重点培育实验室
国家自然科学基金面上项目(82171119、82201263)、国家重点研发计划(2023YFC2507900)、研究生实践创新项目(2023SJ148)
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目的 多维度探讨嗜酸性粒细胞型慢性鼻窦炎伴鼻息肉(eCRSwNP)对患者心理健康和生活质量的影响，并探究其发生的相关危险因素。方法 回顾性分析128名慢性鼻窦炎伴鼻息肉(CRSwNP)患者，根据术后组织病理染色中嗜酸性粒细胞(EOS)计数分为eCRSwNP和非嗜酸性粒细胞型(neCRSwNP)，对两组患者的临床资料、心理健康状况和生活质量等进行比较分析，采用单因素分析eCRSwNP发生的潜在影响因素，多因素Logistic回归分析进一步确定eCRSwNP发生的相关危险因素。结果 eCRSwNP组患者睡眠障碍、嗅觉减退、流涕、喷嚏等症状严重程度及鼻腔鼻窦结局测试22条（SNOT-22）总分均显著高于neCRSwNP组。eCRSwNP组的焦虑自评量表(SAS)、抑郁自评量表(SDS)评分均高于neCRSwNP组，且生活质量简表(SF-36)各维度评分均低于neCRSwNP组(P＜0.05)。单因素分析表明：哮喘、鼻中隔偏曲（NSD）、外周血EOS计数及比例、外周血嗜碱性粒细胞(Baso)计数及比例、Lund-Kennedy评分、Lund-Mackay评分是eCRSwNP发生的影响因素(P＜0.05)。多因素 Logistic回归分析发现哮喘、外周血EOS百分比、外周血Baso计数、Lund-Kennedy评分、Lund-Mackay评分是eCRSwNP发生的相关危险因素(P＜0.05)。结论：eCRSwNP患者临床症状更严重，且易伴随焦虑、抑郁等心理问题。术前进行全面评估可有效预测CRSwNP的分型及术后预后。
Objective This study aims to explore the impact of eosinophilic chronic rhinosinusitis with nasal polyps (eCRSwNP) on patients' mental health and quality of life, and identify the associated risk factors associated with its occurrence. Methods A retrospective analysis was conducted on 128 patients with chronic rhinosinusitis with nasal polyps (CRSwNP). Patients were classified into eCRSwNP and noneosinophilic CRSwNP (neCRSwNP) groups based on the eosinophil (EOS) count in postoperative nasal mucosa histopathological staining. Clinical data, psychological health status, and quality of life were compared between the two groups. Univariate analysis was used to identify factors influencing the occurrence of eCRSwNP, and multivariate logistic regression was performed to determine the related risk factors for eCRSwNP. Results The eCRSwNP group exhibited significantly higher severity of symptoms such as sleep disturbances, olfactory decline, rhinorrhea, and sneezing, and had higher total scores on the Sino-nasal Outcome Test-22（SNOT-22） compared to the neCRSwNP group. Additionally, the eCRSwNP group scored higher on the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS), and lower on all dimensions of the Short Form-36 Health Survey (SF-36) (P < 0.05). Univariate analysis indicated that asthma, nasal septal deviation (NSD), peripheral blood EOS count and percentage, peripheral blood basophil (Baso) count and percentage, Lund-Kennedy score, and Lund-Mackay score were factors influencing the occurrence of eCRSwNP (P < 0.05). Multivariate logistic regression analysis identified asthma, peripheral blood EOS percentage, peripheral blood Baso count, Lund-Kennedy score, and Lund-Mackay score as independent risk factors for eCRSwNP (P<0.05). Conclusion Patients with eCRSwNP exhibit more severe clinical symptoms and are more prone to emotional disorders such as anxiety and depression. Comprehensive preoperative evaluation helps to accurately predict the subtype of CRSwNP and the postoperative course of the disease.
