Objective: To compare the value of sinonasal CT scan with other clinical parameters in the pre-diagnosis of eosinophilic chronic rhinosinusitis with nasal polyps (eCRSwNP). Methods: From January to May of 2016, One hundred and fifty consecutive CRSwNP patients (90 eCRSwNP and 60 non-eosinophilic CRSwNP) undergoing endoscopic functional sinus surgery in Beijing Tongren Hospital were recruited in this study. Preoperative CT scan, skin prick test (SPT) and oral fractional exhaled nitric oxide (FeNO) measurements were performed in each patient and full blood count with differential analysis was performed within 1 week before surgery. t test and X2 test were used to compare the age, gender, history of surgery, onset of asthma, history of allergy, CT scores' ratio for the ethmoid sinus and maxillary sinus (E/M ratio) and presence of osteoneogenesis of two groups. Mann-Whitney analysis was used to compare the total Lund-Mackay scores, FeNO and blood eosinophil counts of two groups. Logistic regression analysis and receiver operating characteristic (ROC) curve were used to assess the predictive value of clinical parameters. Results: E/M ratio, FeNO, blood eosinophil percentage of eCRSwNP group was significantly higher than those of non-eosinophilic CRSwNP group [3.56±0.37 vs 1.80±0.10, (34.4±18.1) μg/L vs (22.1±11.7) μg/L, 8.19%±1.50% vs 4.55%±5.60%; χ(2) value was 0.900; t value was 0.994 and 0.900, respectively; all P<0.05]. E/M ratio had the highest predictive value, with area under curve (AUC) value of 0.938. The cut-off point of 2.59 for E/M ratio demonstrated a sensitivity of 94.3% and a specificity of 89.6% for eCRSwNP. Conclusion: The E/M ratio is a more useful predictor in the diagnosis of eCRSwNP compared to other clinical parameters.
目的： 比较鼻窦CT与其他临床指标对于嗜酸粒细胞性慢性鼻－鼻窦炎(CRS)伴鼻息肉(eosinophilic chronic rhinosinusitis with nasal polyps，eCRSwNP)的预诊断价值。 方法： 2016年1—5月连续入组150例于北京同仁医院耳鼻咽喉头颈外科住院的CRS伴鼻息肉患者(90例eCRSwNP，60例非嗜酸粒细胞性CRS伴鼻息肉)，记录所有患者的年龄、性别、既往史等基本特征。所有患者在接受内镜鼻窦手术治疗前1周，均进行鼻窦CT检查、变应原皮肤点刺试验、呼出一氧化氮浓度测量以及外周血常规检查。用t检验和χ(2)检验比较两组间患者的年龄、性别分布、手术史、哮喘史、过敏史、筛窦与上颌窦评分比值、骨质增生出现率以及窦口扩张出现率；用Mann－Whitney分析比较两组间患者的CT总分、呼出一氧化氮浓度及嗜酸粒细胞计数；用Logistic回归分析及受试者工作特征曲线对各临床指标在eCRSwNP的预诊断价值方面进行比较。 结果： eCRSwNP患者的筛窦与上颌窦评分比值、呼出一氧化氮浓度、外周血嗜酸粒细胞百分比均显著高于非嗜酸粒细胞性CRS伴鼻息肉患者[3.56±0.37比1.80±0.10，(34.4±18.1)μg/L比(22.1±11.7)μg/L，8.19%±1.50%比4.55%±5.60%，χ(2)值为0.900，t值分别为0.994、0.900，P值均<0.05]。在CT评分方面，筛窦与上颌窦评分比值具有最高的预测诊断价值，其曲线下面积为0.938。当筛窦与上颌窦评分比值的截断值>2.59时，其敏感度和特异度分别为94.3%和89.6%。 结论： 与其他诊断指标相比，筛窦与上颌窦评分比值对于eCRSwNP有更高的预测诊断价值。.
Keywords: Eosinophilia; Forecasting; Nasal polyps; Sinusitis.