目的比较慢性鼻-鼻窦炎伴鼻息肉(chronic rhinosinusitis with nasal polyps,CRSwNP)与不伴鼻息肉(chronic rhinosinusitis without nasal polyps,CRSsNP)的临床特征,为制定合理治疗策略提供依据.方法回顾性分析2018年11月~2019年12月...目的比较慢性鼻-鼻窦炎伴鼻息肉(chronic rhinosinusitis with nasal polyps,CRSwNP)与不伴鼻息肉(chronic rhinosinusitis without nasal polyps,CRSsNP)的临床特征,为制定合理治疗策略提供依据.方法回顾性分析2018年11月~2019年12月住院手术的苏皖地区225例慢性鼻-鼻窦炎(CRS)患者术前血常规、血生化、血清总IgE(total IgE,tIgE)、特异性IgE(specific IgE,sIgE)、鼻窦CT及术后病理检查等临床资料,进行统计学分析.结果225例中,CRSwNP组148例(65.8%),CRSsNP组77例(34.2%).患者的性别、年龄、住院时间、外周血白细胞及分类、血生化指标在两组间差异无统计学意义(P>0.05).CRSwNP和CRSsNP患者中至少1种变应原阳性分别占34.5%和40.3%,其中尘螨过敏最多见,阳性率分别为23.0%和26.0%,两组间差异均无统计学意义(P>0.05).血清tIgE阳性率、20种变应原slgE浓度等级和阳性率、吸入性及食物性变应原阳性率在两组间差异也均无统计学意义(P>0.05).鼻窦CT扫描Lund-Mackay评分中,两组各鼻窦、窦口鼻道复合体及CT总分CRSwNP组都高于CRSsNP组,差异均有统计学意义(P<0.05).在病理组织中,两组患者淋巴细胞及浆细胞浸润均为60%以上,但嗜酸性粒细胞(Eos)在CRSwNP组的阳性率为43.2%,显著高于CRSsNP组的阳性率22.1%,差异有统计学意义(P<0.05).结论本地区CRS患者目前仍以淋巴细胞/浆细胞性炎症为主,但CRSwNP息肉组织中Eos阳性率达43.2%,需引起重视并进一步关注.CRSwNP和CRSsNP患者变应原阳性率分别为34.5%和40.3%,两者无明显差异,尘螨为主要致敏原.展开更多
Nasal swabs are non-invasive testing methods for detecting diseases by collecting samples from the nasal cavity or nasopharynx.Dysosmia is regarded as an early sign of coronavirus disease 2019(COVID-19),and nasal swab...Nasal swabs are non-invasive testing methods for detecting diseases by collecting samples from the nasal cavity or nasopharynx.Dysosmia is regarded as an early sign of coronavirus disease 2019(COVID-19),and nasal swabs are the gold standard for the detection.By nasal swabs,severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)nucleic acids can be cyclically amplified and detected using real-time reverse transcriptase-polymerase chain reaction after sampling.Similarly,olfactory dysfunction precedes the onset of typical clinical manifestations by several years in prion diseases and other neurodegenerative diseases,such as Alzheimer’s disease,Parkinson’s disease,dementia with Lewy bodies,and multiple system atrophy.In neurodegenerative diseases,nasal swab tests are currently being explored using seed amplification assay(SAA)of pathogenic misfolded proteins,such as prion,α-synuclein,and tau.These misfolded proteins can serve as templates for the conformational change of other copies from the native form into the same misfolded form in a prion-like manner.SAA for misfolded prion-like proteins from nasal swab extracts has been developed,conceptually analogous to PCR,showing high sensitivity and specificity for molecular diagnosis of degenerative diseases even in the prodromal stage.Cyclic amplification assay of nasal swab extracts is an attractive and feasible method for accurate and non-invasive detection of trace amount of pathogenic substances for screening and diagnosis of neurodegenerative disease.展开更多
基金supported by the National Natural Science Foundation of China(U1904207 to Dr.Yuming Xu)the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences(2020-PT310-01 to Dr.Yuming Xu).
文摘Nasal swabs are non-invasive testing methods for detecting diseases by collecting samples from the nasal cavity or nasopharynx.Dysosmia is regarded as an early sign of coronavirus disease 2019(COVID-19),and nasal swabs are the gold standard for the detection.By nasal swabs,severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)nucleic acids can be cyclically amplified and detected using real-time reverse transcriptase-polymerase chain reaction after sampling.Similarly,olfactory dysfunction precedes the onset of typical clinical manifestations by several years in prion diseases and other neurodegenerative diseases,such as Alzheimer’s disease,Parkinson’s disease,dementia with Lewy bodies,and multiple system atrophy.In neurodegenerative diseases,nasal swab tests are currently being explored using seed amplification assay(SAA)of pathogenic misfolded proteins,such as prion,α-synuclein,and tau.These misfolded proteins can serve as templates for the conformational change of other copies from the native form into the same misfolded form in a prion-like manner.SAA for misfolded prion-like proteins from nasal swab extracts has been developed,conceptually analogous to PCR,showing high sensitivity and specificity for molecular diagnosis of degenerative diseases even in the prodromal stage.Cyclic amplification assay of nasal swab extracts is an attractive and feasible method for accurate and non-invasive detection of trace amount of pathogenic substances for screening and diagnosis of neurodegenerative disease.
