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首页> 外文期刊>American journal of rhinology & allergy >The importance of local eosinophilia in the surgical outcome of chronic rhinosinusitis: A 3-year prospective observational study
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The importance of local eosinophilia in the surgical outcome of chronic rhinosinusitis: A 3-year prospective observational study

机译：局部嗜酸粒细胞增多在慢性鼻-鼻窦炎手术结果中的重要性：一项为期三年的前瞻性观察研究

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Background: Patients with chronic rhinosinusitis with/without nasal polyps (CRSwNP/CRSsNP) benefit from endoscopic sinus surgery (ESS), with an estimated success rate of 80%. At present, the influence on clinical outcome after ESS of eosinophils, eosinophilic mucin (EM), and fungal hyphae (FH) in secretions remains unclear. By delineating CRS groups and subgroups based on the finding of eosinophils, EM, and FH, differences in recurrence after ESS were investigated. Methods: A prospective monocenter study including 221 CRS patients who were unresponsive to medical treatment and underwent ESS was performed. All tissue and sinonasal secretions were microscopically examined for the presence of eosinophils, EM, and FH. Patients were followed for 3 years after surgery. Recurrence was defined according to the European position paper on rhinosinusitis and nasal polyps. Results: In total, 96 CRSwNP and 125 CRSsNP patients were included. Tissue eosinophils were found in 78% of CRSwNP patients compared with 42% in CRSsNP patients. EM was observed in 52% of the CRSwNP group versus 20% of the CRSsNP group. Furthermore, secretion analysis revealed FH in 7% of CRS. Recurrence in the total group was 22% over 3 years. CRSwNP patients with tissue eosinophilic involvement showed a recurrence rate of 48%, and those with additional EM showed recurrence in 56%. Conclusion: The presence of eosinophils in tissue or airway secretions greatly increases the risk of recurrent disease in CRSwNP patients. The finding of tissue eosinophilia and EM provides valuable information regarding the increased likelihood of CRS recurrence after ESS, whereas the finding of FH does not.
机译：背景：患有/不患有鼻息肉（CRSwNP / CRSsNP）的慢性鼻-鼻窦炎患者受益于内窥镜鼻窦手术（ESS），估计成功率为80％。目前，尚不清楚分泌液中嗜酸性粒细胞，嗜酸性粘蛋白（EM）和真菌菌丝（FH）对ESS的临床结局的影响。通过根据嗜酸性粒细胞，EM和FH的发现划定CRS组和亚组，研究了ESS后复发的差异。方法：进行了一项前瞻性单中心研究，研究对象包括221名对药物治疗无效并接受ESS的CRS患者。显微镜检查所有组织和鼻窦分泌物是否存在嗜酸性粒细胞，EM和FH。术后对患者进行了3年的随访。根据欧洲关于鼻-鼻窦炎和鼻息肉的立场文件定义复发。结果：总共包括96名CRSwNP和125名CRSsNP患者。在CRSwNP患者中发现组织嗜酸性粒细胞为78％，而在CRSsNP患者中为42％。在CRSwNP组中有52％观察到EM，而CRSsNP组中有20％观察到EM。此外，分泌分析显示7％的CRS中有FH。在整个组中，三年内复发率为22％。患有组织嗜酸性粒细胞的CRSwNP患者的复发率为48％，而合并EM的患者则为56％。结论：组织或气道分泌物中存在嗜酸性粒细胞大大增加了CRSwNP患者复发疾病的风险。组织嗜酸性粒细胞增多和EM的发现提供了有关ESS后CRS复发可能性增加的有价值的信息，而FH的发现则不然。

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