不同体质量指数的慢性鼻窦炎伴鼻息肉患者临床特征分析

doi:10.3969/j.issn.1006-7795.2022.06.013

首都医科大学学报 ›› 2022, Vol. 43 ›› Issue (6): 899-904.doi: 10.3969/j.issn.1006-7795.2022.06.013

不同体质量指数的慢性鼻窦炎伴鼻息肉患者临床特征分析

李艳¹, 王麒淇¹, 张宇玲^1,2, 段甦³, 张海波^1,2, 王向东^1,2,3, 蓝凤^1*

1.北京市耳鼻咽喉科研究所, 鼻病研究北京市重点实验室,北京 100005;
2.首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,北京 100730;
3.首都医科大学附属北京同仁医院过敏科,北京 100730

收稿日期:2022-09-06 出版日期:2022-12-21 发布日期:2022-11-30
基金资助:
北京市医院管理局“青苗”人才培养计划(QML20180201),北京市科技新星计划(Z191100001119117),北京市优秀人才青年拔尖(2018000021223ZK12),首都医科大学附属北京同仁医院科研种子基金。

Clinical characteristics of chronic rhinosinusitis with nasal polyps with different body mass index

Li Yan¹, Wang Qiqi¹, Zhang Yuling^1,2, Duan Su³, Zhang Haibo^1,2, Wang Xiangdong^1,2,3, Lan Feng^1*

1. Beijing Institute of Otolaryngology, Beijing Key Laboratory of Nasal Diseases, Beijing 100005, China;
2. Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China;
3. Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China

Received:2022-09-06 Online:2022-12-21 Published:2022-11-30
Contact: ^*E-mail:fenglanent@126.com

摘要/Abstract

摘要： 目的分析不同体质量指数(body mass index,BMI)的慢性鼻窦炎伴鼻息肉(chronic rhinosinusitis with nasal polyps,CRSwNP)患者的临床特征。方法回顾性分析2013至2019年共448例CRSwNP接受鼻内镜手术患者(病例组)和308例接受鼻中隔偏曲手术的无其他鼻部疾病的患者(对照组)的临床资料。按照BMI级别分为非超重组(BMI<25.0kg/m²)、超重&肥胖组(BMI≥25.0kg/m²),结合性别再次分组,比较各组合并哮喘及再手术率的差异。结果 CRSwNP患者外周血嗜酸性粒细胞百分比及伴过敏史比例均高于对照组,差异有统计学意义(P<0.05)。女性CRSwNP患者合并哮喘比例高于男性患者组(31.6% vs 20.7%),男性超重患者多于女性,差异均有统计学意义(P<0.05)。女性超重&肥胖的患者再次手术率为43.6%,高于非超重患者,外周血嗜酸性粒细胞百分比明显低于非超重组患者,差异均有统计学意义(P<0.05)。男性超重&肥胖患者外周血嗜酸性粒细胞百分比低于非超重患者,差异有统计学意义(P<0.05)。结论女性超重&肥胖的CRSwNP患者更容易合并哮喘和复发,控制CRSwNP患者体质量可能对预防女性CRSwNP患者的复发和缓解病情有积极意义。

关键词: 鼻窦炎, 体质量指数, 哮喘, 复发

Abstract: Objective To analysis the clinical characteristics in chronic rhinosinusitis with nasal polyps (CRSwNP) patients with different level of body mass index (BMI). Methods A total of 448 CRSwNP patients and 308 controls with septal deviation in Beijing Tongren Hospital from 2013 to 2019 were recruited retrospectively. According to BMI levels, CRSwNP patients were divided into 2 groups: underweight & normal weight (BMI<25 kg/m²) or overweight & obese (BMI≥25 kg/m²), and the rate of asthma comorbidity and revision surgery were analyzed. Results The percentage of eosinophilis in peripheral blood and the allergy comorbidity rate in CRSwNP patients were significantly higher than those in control group (P<0.05). Further classified the patients by genders, the female patients had higher rate of asthma comorbidity (31.6% vs 20.7%), and male overweight & obese CRSwNP patients were more than female overweight & obese patients. Classified the patients by BMI levels and gender, revision surgery rate of female overweight & obese CRSwNP patients was 43.6%, which was significantly higher than that of female underweight and normal weight patients. The percentage of eosinophil in peripheral blood in female overweight & obese patients was significantly lower than that in underweight and normal weight patients. The percentage of eosinophil in peripheral blood of male overweight & obese patients was significantly lower than that of underweight and normal weight patients. Conclusions The overweight and obesity female CRSwNP patients were susceptible to be with comorbid asthma and recurrence after surgery, and controlling the weight of female patients with CRSwNP may prevent nasal polyps recurrence in the females.

Key words: sinusitis, body mass index, asthma, recurrence

中图分类号:

R765

李艳, 王麒淇, 张宇玲, 段甦, 张海波, 王向东, 蓝凤. 不同体质量指数的慢性鼻窦炎伴鼻息肉患者临床特征分析[J]. 首都医科大学学报, 2022, 43(6): 899-904.

Li Yan, Wang Qiqi, Zhang Yuling, Duan Su, Zhang Haibo, Wang Xiangdong, Lan Feng. Clinical characteristics of chronic rhinosinusitis with nasal polyps with different body mass index[J]. Journal of Capital Medical University, 2022, 43(6): 899-904.

参考文献

[1] Hastan D, Fokkens W J, Bachert C, et al. Chronic rhinosinusitis in Europe—an underestimated disease. A GA²LEN study[J]. Allergy, 2011, 66(9): 1216－1223.
[2] Calus L, Van Bruaene N, Bosteels C, et al. Twelve-year follow-up study after endoscopic sinus surgery in patients with chronic rhinosinusitis with nasal polyposis[J]. Clin Transl Allergy, 2019, 9: 30.
[3] Wang M, Bu X T, Luan G, et al. Distinct type 2-high inflammation associated molecular signatures of chronic rhinosinusitis with nasal polyps with comorbid asthma[J]. Clin Transl Allergy, 2020, 10: 26.
[4] Laidlaw T M, Mullol J, Woessner K M, et al. Chronic rhinosinusitis with nasal polyps and asthma[J]. J Allergy Clin Immunol Pract, 2021, 9(3): 1133－1141.
[5] Wang X D, Zhang N, Bo M Y, et al. Diversity of T_H cytokine profiles in patients with chronic rhinosinusitis: a multicenter study in Europe, Asia, and Oceania[J]. J Allergy Clin Immunol, 2016, 138(5): 1344－1353.
[6] Jiang W X, Cao P P, Li Z Y, et al. A retrospective study of changes of histopathology of nasal polyps in adult Chinese in central China[J]. Rhinology, 2019, 57(4): 261－267.
[7] Wang W Q, Gao Y L, Zhu Z Z, et al. Changes in the clinical and histological characteristics of Chinese chronic rhinosinusitis with nasal polyps over 11 years[J]. Int Forum Allergy Rhinol, 2019, 9(2): 149－157.
[8] Velasquez N, Gardiner L, Cheng T Z, et al. Relationship between socioeconomic status, exposure to airborne pollutants, and chronic rhinosinusitis disease severity[J]. Int Forum Allergy Rhinol, 2022, 12(2): 172－180.
[9] Wang L M, Zhou B, Zhao Z P, et al. Body-mass index and obesity in urban and rural China: findings from consecutive nationally representative surveys during 2004－18[J]. Lancet, 2021, 398(10294): 53－63.
[10] 马淑婧, 张艳青, 羊柳, 等. 1991—2015年中国9个省份儿童青少年超重和肥胖率的变化趋势分析[J]. 中华预防医学杂志, 2020, 54(2): 133－138.
[11] Ho W C, Lin Y S, Caffrey J L, et al. Higher body mass index may induce asthma among adolescents with pre-asthmatic symptoms: a prospective cohort study[J]. BMC Public Health, 2011, 11: 542.
[12] Nam J S, Roh Y H, Fahad W A, et al. Association between obesity and chronic rhinosinusitis with nasal polyps: a national population-based study[J]. BMJ Open, 2021, 11(5): e047230.
[13] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组, 中华医学会耳鼻咽喉头颈外科学分会鼻科学组. 中国慢性鼻窦炎诊断和治疗指南(2018)[J]. 中华耳鼻咽喉头颈外科杂志, 2019, 54(2): 81－100.
[14] Fokkens W J, Lund V J, Hopkins C, et al. European position paper on rhinosinusitis and nasal polyps 2020[J]. Rhinology, 2020, 58(Suppl S29): 1－464.
[15] 中华医学会呼吸病学分会哮喘学组. 支气管哮喘防治指南(2020年版)[J]. 中华结核和呼吸杂志, 2020, 43(12): 1023－1048.
[16] 李景云, 张媛, 张罗. 鼻息肉患者上皮间质样转化状态研究[J]. 中华耳鼻咽喉头颈外科杂志, 2016, 51(3): 174－178.
[17] Cnattingius S, Villamor E. Weight change between successive pregnancies and risks of stillbirth and infant mortality: a nationwide cohort study[J]. Lancet, 2016, 387(10018): 558－565.
[18] Smith C J, Perfetti T A, Hayes A W, et al. Obesity as a source of endogenous compounds associated with chronic disease: a review[J]. Toxicol Sci, 2020, 175(2): 149－155.
[19] Miethe S, Karsonova A, Karaulov A, et al. Obesity and asthma[J]. J Allergy Clin Immunol, 2020, 146(4): 685－693.
[20] Stevens W W, Peters A T, Suh L, et al. A retrospective, cross-sectional study reveals that women with CRSwNP have more severe disease than men[J]. Immun Inflamm Dis, 2015, 3(1): 14－22.
[21] Zaitsu M, Narita S I, Lambert K C, et al. Estradiol activates mast cells via a non-genomic estrogen receptor-alpha and calcium influx[J]. Mol Immunol, 2007, 44(8): 1977－1985.
[22] Ahn J C, Kim J W, Lee C H, et al. Prevalence and risk factors of chronic rhinosinusitus, allergic rhinitis, and nasal septal deviation: results of the Korean national health and nutrition survey 2008－2012[J]. JAMA Otolaryngol Head Neck Surg, 2016, 142(2): 162－167.
[23] Clarhed U K E, Schiöler L, Torén K, et al. BMI as a risk factor for the development of chronic rhinosinusitis: a prospective population-based study[J]. Eur Arch Otorhinolaryngol, 2022, 279(10): 4953－4959.
[24] Chung S D, Chen P Y, Lin H C, et al. Comorbidity profile of chronic rhinosinusitis: a population-based study[J]. Laryngoscope, 2014, 124(7): 1536－1541.
[25] Zein J G, Denson J L, Wechsler M E. Asthma over the adult life course: gender and hormonal influences[J]. Clin Chest Med, 2019, 40(1): 149－161.
[26] Mabalirajan U, Rehman R, Ahmad T, et al. 12/15-lipoxygenase expressed in non-epithelial cells causes airway epithelial injury in asthma[J]. Sci Rep, 2013, 3: 1540.
[27] Perakakis N, Farr O M, Mantzoros C S. Leptin in leanness and obesity: JACC state-of-the-art review[J]. J Am Coll Cardiol, 2021, 77(6): 745－760.
[28] Imoto Y, Ueki S, Kato Y, et al. Elevated serum leptin levels in patients with eosinophilic chronic rhinosinusitis[J]. Front Pharmacol, 2021, 12: 793607.
[29] Bektas A, Schurman S H, Sen R, et al. Aging, inflammation and the environment[J]. Exp Gerontol, 2018, 105: 10－18.
[30] Song W J, Lee J H, Won H K, et al. Chronic rhinosinusitis with nasal polyps in older adults: clinical presentation, pathophysiology, and comorbidity[J]. Curr Allergy Asthma Rep, 2019, 19(10): 46.

不同体质量指数的慢性鼻窦炎伴鼻息肉患者临床特征分析

Clinical characteristics of chronic rhinosinusitis with nasal polyps with different body mass index

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	张健雄, 李丹丹, 胡梦梦, 程雪微, 董瑞华. 羧酸酯酶1和羧酸酯酶2基因表达量与体质量指数的关系及其基因多态性分析[J]. 首都医科大学学报, 2023, 44(1): 13-19.
[2]	王剑磊, 朱天, 韩玉, 王月, 汶春苗, 位嘉. 男性尖锐湿疣患者人乳头瘤病毒基因型分布特点及复发危险因素[J]. 首都医科大学学报, 2023, 44(1): 148-153.
[3]	史慕寒, 王冲, 王旻, 袁飞, 邢志敏, 袁晓培, 吴雨潇. 慢性鼻窦炎术后复发额窦炎患者额隐窝气房残留情况的影像及再手术结果分析[J]. 首都医科大学学报, 2022, 43(6): 911-918.
[4]	李昂, 皇惠杰, 杨世青, 侯晓玲, 向莉. 长程治疗管理哮喘儿童的肺功能轨迹特征分析[J]. 首都医科大学学报, 2022, 43(6): 940-947.
[5]	张瑾, 池晶晶, 张蕊, 张小燕, 白文佩. 孕前肥胖及超重女性的孕期管理模式探讨及肥胖相关胎盘因子分析[J]. 首都医科大学学报, 2022, 43(5): 774-781.
[6]	苗祖霈, 张迎花, 肖克令, 司瑾, 张浩宇, 李静. 肥胖程度对急性ST段抬高型心肌梗死患者预后的影响[J]. 首都医科大学学报, 2022, 43(2): 192-198.
[7]	夏宁, 聂秀红, 王昊, 樊晓君. 支气管哮喘合并OSA与冠心病发病率的相关性研究[J]. 首都医科大学学报, 2022, 43(1): 138-142.
[8]	叶小波, 熊天宇, 崔韵, 王明帅, 杨辉, 安卓玲, 牛亦农. 醋酸阿比特龙联合强的松治疗去势抵抗型前列腺癌的疗效分析[J]. 首都医科大学学报, 2021, 42(6): 978-985.
[9]	弓雪峰, 任培中, 崔红生, 姜振远, 张诗瑜, 王佳美, 张馨予, 陈秋仪, 吕明圣, 候丹. 基于网络药理学探讨哮喘宁颗粒防治心理应激哮喘的作用网络与潜在机制[J]. 首都医科大学学报, 2020, 41(4): 576-589.
[10]	王敏, 李颖, 王向东, 张罗. IL-23在慢性鼻窦炎中的表达和作用[J]. 首都医科大学学报, 2020, 41(2): 178-182.
[11]	王明, 卜祥婷, 栾格, 王阳, 王成硕, 张罗. MALAT1在慢性鼻窦炎伴鼻息肉中的表达及对糖皮质激素治疗的反应性[J]. 首都医科大学学报, 2020, 41(2): 183-188.
[12]	杜崑, 郑铭, 王向东, 张罗. 白细胞介素-21与复发性鼻息肉组织中IgE的相关性分析[J]. 首都医科大学学报, 2020, 41(2): 194-199.
[13]	苏万春, 孙宇光, 夏松, 信建峰, 常鲲, 沈文彬. 体质量指数与下肢继发性淋巴水肿预后的分析[J]. 首都医科大学学报, 2019, 40(6): 938-942.
[14]	周平, 刘程, 王秋石, 朱志清, 曹广明, 刘崇东, 张震宇. 人胎盘间充质干细胞治疗小鼠流产的效果研究[J]. 首都医科大学学报, 2019, 40(3): 434-438.
[15]	李莹, 祁森荣, 华琳, 尚佳健. 儿童复发性腮腺炎患者与正常儿童腮腺液微生物群落多样性的差异[J]. 首都医科大学学报, 2018, 39(3): 453-457.