CHRONIC SINUSITIS - RELATIONSHIP OF COMPUTED TOMOGRAPHIC FINDINGS TO ALLERGY, ASTHMA, AND EOSINOPHILIA
CHRONIC SINUSITIS - RELATIONSHIP OF COMPUTED TOMOGRAPHIC FINDINGS TO ALLERGY, ASTHMA, AND EOSINOPHILIA
复制标题
DOI：
10.1001/jama.271.5.363
复制
发表时间：
1994-02-02
影响因子：
120.7
通讯作者：
GROSS, CW
中科院分区：
文献类型：
--
作者：
NEWMAN, LJ;PLATTSMILLS, TAE;GROSS, CW
客观。-开发一种技术来评估慢性鼻窦疾病的严重程度，并检查与过敏，哮喘和嗜酸性粒细胞增多症的相关性。104例慢性鼻窦炎手术患者的调查。一所大学医院的耳鼻喉科诊所。病人。一个成年患者的转诊人群被安排进行内窥镜鼻窦手术是合格的; 104完成问卷调查，并同意参加。审查计算机断层扫描并对疾病程度进行评分。血清样品测定总IgE和特异性IgE抗体常见的吸入性过敏原。分析外周血样本的总嗜酸性粒细胞计数。手术活检标本进行检查嗜酸性粒细胞和培养的细菌和真菌。39%的受试者存在广泛性疾病，与哮喘、特异性IgE抗体和嗜酸性粒细胞增多相关，但与总IgE升高无关。在外周嗜酸性粒细胞增多的患者中，87%的患者有广泛的疾病。所有培养物均生长需氧菌;厌氧菌和真菌不常见。我们提出了一个系统，用于定量的疾病程度，使用计算机断层扫描的慢性鼻窦炎患者。公认的慢性鼻窦炎与哮喘和过敏症的关系似乎仅限于广泛性疾病组。鼻窦炎患者外周血嗜酸性粒细胞增多提示鼻窦炎广泛存在的可能性很高。
Objective.-To develop a technique for evaluating the severity of chronic sinus disease and to examine the correlation with allergy, asthma, and eosinophilia.Design.-A survey of 104 patients undergoing surgery for chronic sinusitis.Setting.-A university hospital ear, nose, and throat clinic.Patients.-A referral population of adult patients being scheduled for endoscopic sinus surgery was eligible; 104 completed questionnaires and agreed to participate.Main Outcome Measures.-Computed tomographic scans were reviewed and scored for extent of disease. Serum samples were assayed for total IgE and specific IgE antibodies to common inhalant allergens. Peripheral blood samples were analyzed for total eosinophil count. Surgical biopsy specimens were examined for eosinophilia and cultured for bacteria and fungi.Results.-Extensive disease was present in 39% of subjects and correlated well with asthma, specific IgE antibodies, and eosinophilia, but not with elevated total IgE. Among patients with peripheral eosinophilia, 87% had extensive disease. All cultures grew aerobic bacteria; anaerobes and fungi were uncommon.Conclusions.-We present a system for quantitation of disease extent using computed tomographic scans of patients with chronic sinusitis. The well-accepted associations of chronic sinusitis with asthma and allergy appear to be restricted to the group with extensive disease. The presence of peripheral eosinophilia in patients with sinusitis indicates a high likelihood of extensive disease.