| Objective This paper aims to explore the lesions of mucosal tissue respectively in chronic rhinosinusitis(chronic sinusitis, CRS) patients, then according to the eosinophils and neutrophils infiltrating classification, after that comparative analysis of the clinical symptoms, the clinical characteristics of various aspects of peripheral blood eosinophils and neutrophils the percentage of peripheral blood, serum total Ig E, allergy, the immune pathology, seek the clinical rapid classification basis, to provide theoretical basis for rhinosinusitis in diseases classified treatment.Method First, understand the patients’ HPI and past history, wether there is nasal congestion, runny nose, headache, dizziness, hyposmia, memory and hearing loss, decreased attention;or wether is associated with asthma, hypertension, diabetes, coronary heart disease, eliminate the possible impact on the test. Secondly, do the blood routine, the total Ig E, sinus CT, anterior rhinoscopy, skin prick test, peripheral blood serum and perfect all kinds of preoperative routine examination. Finally, the postoperative pathology examination were classified and manual counting eosinophils and neutrophils, then the eosinophils infiltration and neutrophils infiltration are compared. The details are as follows: 1.Collected from sep 2013 to sep 2014 in otolaryngology head and neck surgery of the First Affiliated Hospital of Medical University Of Anhui, clinical symptoms and sinus CT confirmed chronic nasal sinusitis with or without nasal polyps in 320 patients of which all index of complete collection in 130 cases. Clinical symptoms wereneutrophils; skin prick test results wether have allergy, allergen species and allergic reaction degree, understanding the relationship between allergen and inflammation of nasal sinus disease; simultaneous detection of total Ig E expression from peripheral blood in serum. 2.According to the type of the postoperative pathological results showed inflammatory cell infiltration is divided into invasive rhinosinusitis invasive sinusitis of neutrophil and eosinophil. This type of comparison of the above data, the application SPSS19.0 statistical software for statistical analysis and comparison of data, statistical methods using chi-square test(x2), Mann-Whitney Test(Z), t test(t).Result 130 cases of chronic rhinosinusitis in patients with postoperative pathological examination showed 100 cases with infiltration of eosinophils, and the neutrophils infiltration is 30 cases. The distribution of age between 6 to 76 years old, the average age of eosinophils is 40.62 years; the average age of neutrophils is 34.07 years. Eosinophilic granulocyte type: 1.Clinical symptoms: nasal obstruction(90 cases), purulent nasal secretions(65 cases), nasal mucosa hyperemia(35 cases), nasal polyps(60 cases), dizziness, pain(56 cases), hyposmia(49 cases), memory decline(14 cases), hearing loss(5 cases), trouble concentrating(6 cases). 2.Pathological types: edema type(56 cases), fiber hyperplasia(15 cases), glandular type(21 cases), interstitial specific nuclear cell type(0 cases), edema + fiber type(0 cases), edema + glandular type(8 cases). The neutral granular cell type:1.Clinical symptoms: nasal obstruction(28 cases), purulent nasal secretions(19 cases), nasal mucosa hyperemia(10 cases), nasal polyps(13 cases), dizziness, pain(21 cases), hyposmia(16 cases), memory decline(12 cases), hearing loss(3 cases), trouble concentrating(3 cases). 2. Pathological types: edema type(17 cases), fiber hyperplasia(3 cases), glandular type(8 cases), interstitial specific nuclear cell type(1 cases), edema + fiber type(1 cases), edema + glandular type(0 cases). Eosinophils and neutrophils type other records of the results of comparative statistical analysis as follows: 1. Statistical analysis results for sex: Chi-square test was 2=2.503, P=0.114, P>0.05, no significant difference. 2. CRSw NP and CRSs NP statistical analysis results: Chi-square test X- =1.222, P=0.269, P>0.05, no significant difference. 3. Statistical analysis results for the number of allergens: Chi-square test X- =1.214, P=0.270, P>0.05, no significant difference. 4 The total Ig E of peripheral blood serum the results of statistical analysis for: Mann-Whitney Test Z=-1.299, P=1.94, P>0.05, no significant difference. 5. Peripheral blood eosinophil percentage statistical analysis results: Mann-Whitney Test Z=-2.882, P=0.04, P<0.05, the difference was statistically significant. 6. Peripheral blood neutrophil percentage statistics analysis results: T test t=0.396, P=0.694, P>0.05, no significant difference.Conclusion 1. Peripheral blood eosinophil correlation between eosinophil and neutrophil granulocyte percentage of acid and pathological tissue infiltration degree. Peripheral blood eosinophils and local eosinophil infiltration degree show consistency, thussuggesting that the group of indexes can be used as a preliminary judge eosinophil infiltration degree index. 2. No correlation with gender, total Ig E of peripheral blood, peripheral blood neutrophil percentages, CRSw NP and CRSs NP, skin prick test results and immunopathology of eosinophil and neutrophil infiltration degree. 3. On the basis of eosinophil infiltration and the infiltration of neutrophils were mainly classified treatment, the better the former steroid hormone effect, the latter of macrolide antibiotics effect is good, it also requires us to the next step postoperative follow-up to confirm. The type and treatment is of significance in guiding drug therapy and reduce chronic nasal sinusitis with nasal polyp recurrence rate, improve the therapeutic effect in order to improve the quality of life of patients. Then the prognosis patients coping with eosinophils infiltration degree of correlation to do further study. |
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