【摘要】 目的:分析慢性鼻窦炎（CRS）不伴下呼吸道疾病患者的肺功能，并进一步探讨CRS与下呼吸道疾病之间的因果关系。方法:回顾性分析不伴下呼吸道疾病的CRS患者138例，鼻中隔偏曲患者34例，以及鼻内镜手术后随访至3个月的54例患者的临床资料。所有患者根据有无鼻窦炎及鼻息肉（NP）分为对照组、不伴鼻息肉组（CRSsNP）、单侧NP组和双侧NP组；观察血清IgE、外周血嗜酸性粒细胞计数（PBEC）、CT评分、内镜评分及肺通气功能等指标。结果:不同组别患者性别、年龄、吸烟人数、烟龄及外周血IgE水平各组间比较无统计学差异（均P>0.05）。双侧NP组的病程与CRSsNP组相比有统计学差异（P<0.05）。与对照组及CRSsNP组相比，双侧NP组鼻窦CT评分、鼻内镜评分以及PBEC间比较有统计学差异（均P<0.05）,其肺功能指标（FEV₁%、FEV₁/FVC%）有明显下降（均P<0.05）,FVC%各组间比较无统计学差异（均P>0.05）。鼻窦CT评分与FEV₁%及FEV₁/FVC%之间存在负相关性（P<0.05）,鼻内镜CT评分及PBEC与FEV₁%之间也存在负相关性（P<0.05）。经鼻内镜手术治疗3个月后，患者鼻腔情况均有不同程度的改善，术后患者的肺功能指标（FEV₁%及FEV₁/FVC%）比术前有明显提高（均P<0.05）。结论:在不伴下呼吸道疾病CRS患者中存在肺功能指标下降，经过鼻内镜手术治疗后，其肺功能可明显改善。因此，如果对单纯性肺功能下降而不伴下呼吸道疾病及症状的CRS患者在早期给予规范的临床治疗，有可能降低CRS患者并发下呼吸道系统疾病的风险。更多还原

【Abstract】 Objective:To analyze the pulmonary function in chronic rhinosinusitis（CRS） patients without lower respiratory tract disease, and to further explore the causal relationship between CRS and lower respiratory tract disease.Methods:The clinical data of patients without lower respiratory tract disease were retrospectively analyzed, including 138 patients with CRS,34 patients with nasal septum deviation, and 54 patients followed up for 3 months after endoscopic sinus surgery.All patients were classified into four groups according to the presence or absence of CRS or nasal polyps（NP）:control group, CRSsNP group, unilateral NP group and bilateral NP group.The main items for observation included serum IgE,peripheral blood eosinophil count（PBEC）,sinus CT score, endoscopic score and pulmonary function parameters.Results:There were no significant differences in gender, age, smokers, smoking duration and serum IgE among different groups（all P>0.05）.The course of disease in bilateral NP group was significantly different from that in CRSsNP group（P<0.05）.Compared with the control group and CRSsNP group, there were significant differences in sinus CT score, nasal endoscopy score and peripheral blood eosinophil count in bilateral NP group（all P<0.05）,and the pulmonary function indexes（FEV₁% and FEV₁/FVC%） were significantly decreased（all P<0.05）,while there was no significant change in FVC% among groups（all P>0.05）.There was negative correlation between sinus CT score and FEV₁%,FEV₁/FVC%（all P<0.05）,and FEV₁% was also negatively correlated with endoscopic score, peripheral blood eosinophil count（all P<0.05）.After 3 months of follow-up, nasal conditions and pulmonary function indexes（FEV₁%,FEV₁/FVC%） of patients undergoing endoscopic surgery were improved compared with those before operation（all P<0.05）.Conclusion:The pulmonary function parameters of CRS patients without lower respiratory tract disease are decreased, and significantly improved after endoscopic sinus surgery.Therefore, if CRS patients with simple pulmonary function impairment and without lower respiratory diseases or symptoms received early standardized clinical treatment, and the risk of lower respiratory tract disease may be reduced.更多还原