| 【Objective】To explore different years(CRSw NP)in patients with chronic sinusitis and nasal polyp and chronic sinusitis with nasal polyps(CRSs NP)in the blood eosinophil,neutrophils,monocytes and lymphocytes,eosinophils in change and organization changes,neutrophils,lymphocytes,plasma cells,and the patient’s CT Lund-Mackay score changes,understand each other,thus speculated that the onset of CRSw NP factors change.【Method】Retrospective analysis was performed on 430 cases of CRSw NP and 225 cases of CRSs NP that were hospitalized for surgical treatment in otolaryngology department of jiangsu university hospital in 2008,2012 and 2016.Reasonable inclusion and exclusion criteria were established,and case data that met the research criteria were collected.Clinical data of 145 patients diagnosed with CRSw NP in 2008,145 in 2012,and 140 patients diagnosed with CRSw NP in 2016,as well as clinical data of 84 patients diagnosed with CRSs NP in 2008,80 patients diagnosed with CRSw NP in 2012,and 61 patients diagnosed with CRSs NP in2016.1.Observed the blood routine examination results of the patient upon admission,and analyzed the changes of eosinophils,neutrophils,lymphocytes and monocytes.2.The number of eosinophils,neutrophils,lymphocytes and plasma cells in the postoperative histopathological sections.3.Retrospective analysis was performed on 321 cases of CRSw NP(113 cases in2008,112 cases in 2012,96 cases in 2016)and 165 cases of CRSs NP(70 cases in2008,54 cases in 2012,41 cases in 2016)with preserved imaging data.【Results】1.Chi-square test was used to analyze the gender,CRSw NP and CRSs NP distribution of patients in three different time periods,and the difference was not statistically significant(P > 0.05).2.The chi-square test was used to analyze the gender,CRSw NP and CRSs NP distribution of age factors in the incidence of CRS,and the difference was not statistically significant(P > 0.05).3.Non-parametric test was used to analyze the inflammatory cells of CRSw NP and their total number in three different time periods(1)There was no statistically significant difference in eosinophils in the peripheral blood of patients with nasal polyps in different years(P > 0.05),while the eosinophil count in nasal polyps increased year by year(P < 0.05).(2)The percentage of neutrophils and lymphocytes in the serum of patients with nasal polyps increased in 2012 and 2016(P < 0.05),while there was no statistical difference between 2016 and 2012(P > 0.05).(3)The increase of neutrophil count in nasal polyp tissue was only statistically significant in 2016 compared with that in 2008(P < 0.05),while there was no statistically significant difference in other years(P > 0.05).(4)The percentage of lymphocytes in the peripheral blood of patients with nasal polyps decreased year by year with statistical difference(P < 0.05),while the lymphocyte count in the tissue showed no annual change trend(P > 0.05).4.Non-parametric test was used to analyze CRSs NP inflammatory cells and their total number in three different time periods(1)There was no significant difference in EOS% and monocyte percentage in patients’ peripheral blood in three different time periods(P > 0.05).(2)The percentage of neutrophils and lymphocytes in patients’ peripheral blood increased significantly in 2012 compared with 2008(P < 0.05),while there was no significant statistical difference in other years(P > 0.05).(3)The number of EOS and neutrophils in the pathological tissues increased significantly in 2016 compared with that in 2008 and 2012,with statistically significant differences(P < 0.05),and no statistically significant differences in other years(P > 0.05).(4)The lymphocyte and plasma cell counts in the pathological tissues showed no significant change trend in years(P > 0.05).5.Non-parametric test was used to analyze CRSw NP and CRSs NP inflammatory cells in three different time periods and their total number(1)Over the three time periods,the Eos count in the polyp tissue of CRSw NP group was significantly higher than that of the CRSs NP group,with statistical significance(P < 0.05).The Eos count level in the CRSw NP group increased continuously,while the Eos count in the CRSw NP group increased slowly,which was statistically significant only in 2016 compared with the two groups(P < 0.05).(2)In the three time periods,the neutrophil count of polyps in the CRSs NP group was significantly higher than that in the CRSw NP group(P < 0.05).(3)The ratio of EOS/ neutrophil in polyp tissues of CRSw NP group was significantly higher in 2008 and 2016 than that of CRSs NP group,with statistical significance(P < 0.01).The ratio of EOS/ neutrophil in CRSw NP group was significantly higher in 2016 than that in 2008 and 2012(P < 0.05),while there was no significant difference between the two groups(P > 0.05).6.Pearson correlation analysis was used:(1)There was a significant negative correlation between the percentage of eosinophils and neutrophils in the peripheral blood of CRSw NP patients in different years: in 2008(r=-0.464,P =0.000);2012(r=-0.342,P =0.000);2016(r=-0.507,P =0.000).(2)In CRSw NP patients,there was a significant positive correlation between the percentage of eosinophils in peripheral blood and the number of eosinophils in pathological tissues in 2008(r=0.313,P =0.000).In 2012 and 2016,there was a weak positive correlation(r=0.157,P =0.047;r = 0.160,P = 0.049).(3)There was a significant negative correlation between eosinophil count and neutrophils,lymphocytes and plasma cells in nasal polyps of CRSw NP patients in2016(r=-0.236,P =0.005.r= 0.230,P = 0.006;r = 0.465,P = 0.000).【Conclusion】Over time,the inflammatory pattern of nasal polyp tissues in this region changed significantly.Compared with CRSs NP,the Eos of nasal polyp tissues in patients with CRSw NP increased significantly,and the proportion in the total number of inflammatory cells increased.Neutrophils increased in different periods,but the increase was not significant compared with that of CRSs NP,which may be related to the increase in the proportion of eosinophilic inflammation caused by environmental changes and the decrease in the proportion of infectious factors.There was a significant positive correlation between PBE count level and tissue Eos infiltration in patients with nasal polyps,which could be used as one of the reference indicators for clinical diagnosis of ECRSw NP. |
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