慢性鼻-鼻窦炎患者嗅觉障碍患病情况及其影响因素

doi:10.12183/j.scjpm.2020.0014

摘要/Abstract

摘要： 目的分析慢性鼻-鼻窦炎(CRS)伴嗅觉障碍发生情况及其影响因素,为制定相应干预措施提供依据。方法以2018年辽宁省阜新市某医院就诊的成年CRS患者为研究对象,进行问卷调查、T&T嗅觉功能检查、血清总免疫球蛋白E(IgE)水平检测及鼻内镜Lund-Kennedy评分。采用单、多因素分析方法对CRS伴嗅觉障碍发生影响因素进行分析。结果本研究共对340例CRS患者进行研究,平均年龄(45.73 ± 10.14)岁,以41~64岁为主,占45.88%,男性占65.00%,女性占35.00%。CRS伴嗅觉障碍患病率为44.12%。多因素分析结果显示,血清总IgE水平阳性(OR=1.526)、Lund-Kennedy评分≥2分(OR=2.813)、前期鼻内镜手术史(OR=1.504)、哮喘史(OR=1.870)、鼻息肉(OR=2.139)、阿司匹林不耐受(OR=1.317)是CRS伴嗅觉障碍的危险因素。结论辽宁省阜新市CRS伴嗅觉障碍患病率处于高水平,其危险因素有哮喘史、前期鼻内镜手术史、鼻息肉、阿司匹林不耐受、血清总IgE水平阳性、Lund-Kennedy评分≥2分等,建议采取相应干预措施降低CRS伴嗅觉障碍患病率。

关键词: 慢性鼻-鼻窦炎, 嗅觉障碍, 患病率, 影响因素

Abstract: Objective To analyze the prevalence of chronic rhinosinusitis (CRS) with olfactory disorder and its influencing factors, so as to provide evidence for making corresponding intervention measures. Methods Adult patients with CRS were selected from a hospital in Fuxin City, Liaoning Province in 2018 to conduct a questionnaire survey, T&T olfactory function test, serum total immunoglobulin E (IgE) test, and Lund-Kennedy endoscopic scoring. Univariate and multivariate logistic regressions were used to analyze the influencing factors of CRS with dysosmia. Result sA total of, 340 patients with CRS were enrolled, with an average age of (45.73 ± 10.14) years. Of them, 45.88% aged 41-64 years, 65.00% were males, and 35.00% were females. The prevalence of CRS with olfactory disorder was 44.12%. Multivariate logistic regression showed that the positive serum total IgE level (OR=1.526), ??Lund-Kennedy scores≥2 (OR=2.813), previous nasal surgery history (OR=1.504), asthma (OR=1.870), nasal polyps (OR=2.139), and aspirin intolerance (OR=1.317) were independent risk factors for the prevalence of CRS with dysosmia. Conclusion The prevalence of CRS with olfactory disorder in Fuxin City, ??Liaoning Province was at a high level. The risk factors included asthma, history of nasal surgery, nasal polyps, aspirin intolerance, positive serum total IgE level, and Lund-Kennedy score≥2,it is recommended to take appropriate interventions to reduce the prevalence of CRS with dysosmia.

Key words: Chronic rhinosinusitis, Olfactory disorder, Prevalence, Influencing factors

中图分类号:

R195.4

张星, 王震, 雷莉. 慢性鼻-鼻窦炎患者嗅觉障碍患病情况及其影响因素[J]. 华南预防医学, 2020, 46(1): 14-17.

ZHANG Xing, WANG Zhen, LEI Li. Prevalence and influencing factors of olfactory disturbance in patients with chronic rhinosinusitis[J]. South China Journal of Preventive Medicine, 2020, 46(1): 14-17.

参考文献

[1] 刘剑锋,韩军,韩红蕾,等.嗅觉障碍的治疗现状[J].中华耳鼻咽喉头颈外科杂志,2018,53(7):544-549.
[2] Gao Y,Zheng M,Cui L,et al.IgG4-related disease: association between chronic rhino-sinusitis and systemic symptoms[J].Eur Arch Oto-Rhino-Laryngol,2018,275(8):2013-2019.
[3] 甄甄,廖波,李志勇,等.慢性鼻-鼻窦炎患者嗅觉障碍影响因素分析[J].临床耳鼻咽喉头颈外科杂志,2014,28(17):1282-1284.
[4] 顾东升,李佩忠.慢性鼻窦炎与嗅觉障碍[J].中国眼耳鼻喉科杂志,2014,14(2):127-129.
[5] 任军,皇甫辉.慢性鼻-鼻窦炎伴嗅觉障碍患者鼻内镜手术前后嗅觉变化分析[J].临床耳鼻咽喉头颈外科杂志,2016,30(2):106-110.
[6] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组.慢性鼻-鼻窦炎诊断和治疗指南(2012年,昆明)[J].中国医刊,2013,48(11):92-94.
[7] 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.嗅觉障碍诊断和治疗专家共识(2017年)[J].中华耳鼻咽喉头颈外科杂志,2018,53(7):484-494.
[8] 朱歆洁. 儿童变应性鼻炎严重度与血清嗜酸粒细胞阳离子蛋白的相关性[C].华东六省一市耳鼻咽喉头颈外科年会暨江西省第十三次年会论文集. 2012.
[9] 武鹏. 新型鼻内镜评分系统the discharge,inflammation,and polyps/edema(DIP)评分在慢性鼻-鼻窦炎中的应用[C].2014年浙江省医学会耳鼻咽喉头颈外科学学术年会论文汇编. 2014.
[10] 季立,陆文敏,肖锋,等.鼻内镜下中鼻甲成形术对慢性鼻窦炎伴鼻息肉患者术后鼻腔功能及嗅觉的影响[J].实用临床医药杂志,2018,22(3):86-89.
[11] Wong EH,Do TQ,Harvey RJ,et al.Patient-reported olfaction improves following outside-in Draf III frontal sinus surgery for chronic rhinosinusitis[J].Laryngoscope,2019,129(1):25-30.
[12] 王志恺,王玮,高小平,等.慢性鼻-鼻窦炎伴鼻息肉患者鼻内镜术后嗅觉障碍影响因素分析[J].宁夏医科大学学报,2018,40(5):572-574.
[13] Briner HR,Jones N,Simmen D.Olfaction after endoscopic sinus surgery:long-term results[J].Rhinology,2012,50(2):178-184.
[14] 成雷,贾若,李海洋,等.影响慢性鼻-鼻窦炎嗅觉障碍的相关因素分析[J].中国耳鼻咽喉头颈外科,2019,26(4):37-39.
[15] 王明婕,周兵,崔顺九,等.改良鼻窦CT嗅区评分对慢性鼻-鼻窦炎鼻息肉嗅觉评估及预后判断的价值[J].中国耳鼻咽喉头颈外科,2017,24(6):316-319.
[16] Sonnet MH,Nguyen DT,Nguyenthi PL,et al.Fine-tuned evaluation of olfactory function in patients operated for nasal polyposis[J].Eur Arch Eur Arch Otorhinolaryngol,2017,274(7):2837-2843.
[17] 余滋中,付艳乔,李国义.鼻内镜术后糖皮质激素浸润对慢性鼻-鼻窦炎伴鼻息肉患者近期疗效及嗅觉功能的影响[J].基因组学与应用生物学,2017,36(7):2722-2727.
[18] Vandenhende-Szymanski C,Hochet B,Chevalier D,et al.Olfactory cleft opacity and CT score are predictive factors of smell recovery after surgery in nasal polyposis[J].Rhinology,2015,53(1):29-34.
[19] 汪静波,陈晓云,陈君.慢性鼻窦炎鼻息肉患者鼻内镜术后嗅觉恢复的影响因素分析[J].实用医学杂志,2011,27(7):1216-1218.
[20] 王志婕. 宁夏地区嗅觉障碍自报患病率和危险因素分析[D]. 银川:宁夏医科大学,2018.