| Objective:To explore the relationship between allergy and chronic rhinosinusitis by means of serum total IgE,serum specific IgE,serum eosinophil and tissue eosinophil and the relationship between SIgE and eosinophil.Metods: We collected 72 cases of patients with chronic rhinosinusitis in our department of ENT as experimental group,and select the same period in our hospital 16 cases of nasal septum deviation underwent nasal septum surgery as the control group from june 2016 to february 2017.Chronic rhinosinusitis patients were further divided into chronic sinusitis with nasal polyps(CRSwNP)and chronic nasal sinusitis without nasal polyps(CRSsNP).Chronic rhinosinusitis patients with serum specific IgE(SIgE)positive were divided into SIgE positive group,serum specific IgE(SIgE)negative patients were divided into SIgE negative group.According to the infiltration of eosinophils in patients with chronic rhinosinusitis,the patients were divided into two groups: eosinophil infiltration group(ECRS)and non eosinophilic infiltration group(non-ECRS).The patients,serum TIgE and SIgE was analyzed by FOOKE ALLERG-O-LIQ-SYSTEM allergen detection system,Serum and tissue eosinophils were counted,case history,visual analogue scale scoring,Lund-Mackay CT and Lund — Kennedy Endoscope system scoring was record.Meantime discuss the relationship between allergy and chronic rhinosinusitis by means of serum total IgE,serum specific IgE,serum eosinophil and tissue eosinophil,investigate the effect of serum specific IgE and tissue eosinophils on the severity of symptoms and signs in patients with chronic sinusitis,and the relationship between serun SIgE and eosinophil,TIgE.Results:1、There was no significant difference in serum IgE,serum total IgE and serum eosinophil in CRSwNp group and control group,CRSsNP group and control group,CRSwNP group and CRSsNP group.2、There was a significant difference in VAS score between serum specific IgE positive group and negative group(t=-2.7,p=0.01).The CT score of the serum specific IgE positive group was 12.9,and the average CT score of the negative group was12.1,the difference was not statistically significant(t= = 0.6,p=0.56).The average endoscopy score of IgE in positive group was 7.6,and the average score of endoscopy in negative group was 7.4,There was no significant difference between the two groups(t=0.3,p=0.8).3、There were 11 cases of CRSwNP and 2 case of CRSsNP in the patients with eosinophilic infiltration type,In the non eosinophilic infiltration type,CRSwNP was found in 18 cases and CRSsNP in 19 cases,the difference between the two groups was statistically significant(?2= = 5.1,p=0.02).The mean score of VAS was 20.6 in eosinophil infiltration group,and mean VAS score of non eosinophilic infiltration group was15.4,the difference between the two groups was statistically significant(t=2.1,p=0.04).The mean score of CT was 14.5 in eosinophil infiltration group,and CT score of non eosinophilic infiltration group was about 10.7,the difference was statistically significant(t=2.4,p=0.02).The average score of endoscopic evaluation of eosinophilic infiltration group was 9,and the average score of endoscopic evaluation of non eosinophilic infiltration group was 6.8,the difference was statistically significant(t=2.5,p=0.02).4、In the specific IgE positive group,the average blood eosinophil count was 0.19,and the average blood eosinophil count was 0.18 in the negative group,the difference between the two groups was not statistically significant(t=0.2,p=0.8).In the specific IgE positive group,there were 4 cases of eosinophilic infiltration in the tissue,and there were no infiltrative type in 10 cases;In the specific IgE negative group,there were 10 cases of eosinophilic infiltration in the tissue,and there were no infiltration in the other 24 cases.There was no statistical significance between the two groups(?2=0.003,p=0.96).In the specific IgE positive group,the total serum IgE count was 226.3,and the total IgE count in negative group was about 87.5,and the difference between the two groups was statistically significant(t=3.2,p=0.002).Conclusions:1、The cause of chronic rhinosinusitis is complicated.The single factor such as IgE and eosinophils can not be used as a criterion.2、when the chronic rhinosinusitis patients with allergic state,symptoms and signs of disease severity is not necessarily increased.3 、 Eosinophilic infiltration of chronic rhinosinusitis suggests an increased probability of nasal polyps,and increased severity of the symptoms and signs,The extent of eosinophil infiltration was independent of allergic reactions,there may exist a type of non allergic positive eosinophilic infiltration chronic rhinosinusitis. |
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