Effect Of Postoperative Oral Corticosteroids On Eosinophils In Patients With Eosinophilie Chronic Rhinosinusitis With Nasal Polyps

Objective : Observe the changes of tissue and peripheral blood eosinophils and clinical symptoms in patients with eosinophilic chronic sinusitis and nasal polyps(Eosinophilie chronic rhinosinusitis with nasal polyps;ECRSw NP)after endoscopic sinus surgery(endoscopic sinus surgery,ESS),and to evaluate the effects of oral corticosteroids on tissue and peripheral blood eosinophils and clinical symptoms,so as to provide a new reference for perioperative treatment of ECRSw NP and promote postoperative recovery.Methods:From January 2020 to January 2021,64 patients whose postoperative histopathological examination results were more than 10 eosinophils per high magnification field confirmed with ECRSw NP who were hospitalized in the Department of Otolaryngology Head and neck surgery of the First Affiliated Hospital of Hunan Normal University(Hunan Provincial People’s Hospital)and treated with ESS were included.The patients were divided into three Groupss,the patients in Groups 1 were treated with oral taken prednisone 15 mg / d for 14 days,while the patients in Groups 2 were treated with oral taken prednisone 30 mg / d for 14 days,and the empty control Group was set up meanwhile.In addition,all patients were regularly treated with fluticasone furoate nasal spray and normal saline nasal irrigation.They were followed up at 1 week,1 month and3 months after operation.Blood routine eosinophil count,SNOT-22 score,debridement and Lund Kennedy score were performed in the follow up evaluation,meanwhile,the eosinophils in the mucosa of ostiomeatal complex were detected and counted.Finally,the alteration trend and correlation of eosinophils in peripheral blood and tissues,subjective and objective scores in patients with ECRSw NP were evaluated comprehensively.Results:1.There was significance difference in tissue eosinophil level and Lund-Kennedy score between the experimental groups and the control group(p<0.05).SNOT-22 score and peripheral blood eosinophil count showed a downward trend,but there was no statistical difference(p>0.05).2.There was significance difference in tissue eosinophil count between experimental groups 1 and experimental groups 2(p < 0.05).There was no significant difference in Lund-Kennedy score,SNOT-22 score and eosinophil II count in peripheral blood between experimental groups 1 and experimental groups 2(p >0.05).3.There was a weak correlation between peripheral blood eosinophil count and tissue eosinophil count(0.277),and a strong correlation between Lund-Kennedy score and SNOT-22 score(0.622).Conclusion : After the operation of ECRSwNP,oral glucocorticoid can effectively alleviate the level of eosinophils,improve the prognosis and the quality of life of patients.