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慢性鼻窦炎对慢性阻塞性肺疾病的影响

闫淑丽1,贾玮2,李月川3   

  1. 1. 天津医科大学研究生院
    2. 天津市胸科医院
    3. 天津市胸科医院胸内科
  • 收稿日期:2012-09-24 修回日期:2012-12-20 出版日期:2013-05-15 发布日期:2013-05-15
  • 通讯作者: 贾玮

Research on the impact of chronic rhinosinusitis to COPD

Shu-Li YAN1,JIA WEI2,LI YUE CHUAN   

  • Received:2012-09-24 Revised:2012-12-20 Published:2013-05-15 Online:2013-05-15
  • Contact: JIA WEI

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摘要：

【摘要】 目的探讨慢性鼻窦炎对慢性阻塞性肺疾病(COPD)患者生活质量及其急性加重情况的影响。方法对101例COPD患者进行病史采集,抽血并测定红细胞沉降率(ESR)、C反应蛋白(CRP)、凝血全项,计算入院时CAT评分,回顾本次住院前1年内重度急性加重的次数,记录住院时间。病情稳定后行肺功能、胸部HRCT及鼻窦CT扫描,根据鼻窦CT结果分为单纯COPD组(Ⅰ组)39例,COPD合并慢性鼻窦炎组(Ⅱ组)62例。结果 2组患者年龄、性别、咳喘史、吸烟史及肺功能差异无统计学意义(P>0.05);62例合并慢性鼻窦炎患者有鼻部症状的占62.9%(39/62);最常累及的鼻窦为上颌窦,其次为筛窦;Ⅱ组的CAT评分及过去1年内重度急性加重的次数高于Ⅰ组(P<0.01),但2组ESR、CRP、纤维蛋白原(FIB)及住院时间差异无统计学意义;不同肺功能分级的COPD患者慢性鼻窦炎的发生情况差异无统计学意义。结论慢性鼻窦炎为COPD患者最常见的上呼吸道合并症,合并慢性鼻窦炎的COPD患者急性加重时CAT评分及1年内急性加重的次数明显增加。 

关键词: 慢性阻塞性肺疾病, 慢性鼻窦炎, 血沉, C反应蛋白, 纤维蛋白原, CAT评分

Abstract: Abstract Objective  To investigate chronic sinusitis impact on chronic obstructive pulmonary disease (COPD) patients quality of life and the influence of acute aggravating. Methods   For the 101 patients who met the inclusion criteria in hospital history collection, In the next early morning 6h extraction fasting venous blood samples 20ml,determination of erythrocyte sedimentation rate、 C reactive protein,、blood coagulation items;then we calculated the CAT score, reviewed the acute exacerbations of 1 year before admission hospitalization, recorded the time of hospitalization of each patient enrolled in the study .The patients were divided into two groups : simple COPD group and group of COPD combined with chronic rhinosinusitis, according to the results of paranasal sinus CT scans.Then the data were analyzed through SPSS software(Version 17.0).Results   Sinus CT scan examination showed 101 COPD patients with chronic rhinosinusitis incidence was 64.1%(62/101). 62.9% (39 / 62)of 62 patients with chronic sinusitis had nasal symptoms, while 37.1%（23/62）patients without any nasal symptoms. Maxillary sinus was the most frequently involved 93.55%（58/62）, followed by the ethmoid sinus30.65%（19/62）. CAT scores and the acute exacerbation frequency increased more significantly in the group of combined with chronic rhinosinusitis, than the group of only COPD ( P < 0.05 ), but the two groups when compared to the ESR and CRP, FIB and length of hospital stay indifference, compared with no difference in the occurrence of different classification of lung function in COPD patients with chronic sinusitis.. Conclusion  Chronic rhinosinusitis were the most common upper respiratory tract complications of COPD,and it influents the quality of life and acute exacerbation of the patient. Unfortunately the clinical diagnosis rate is too low,which calls for more attentions.

Key words: chronic obstructive pulmonary disease, chronic sinusitis, blood sedimentation, C-reactive protein, fibrinogen, CAT score