Features of local and systemic indicators in chronic rhinitis

Natalya S. Goncharova, O. Smirnova
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Abstract

Aim. The study of the features of local and systemic indicators in chronic rhinitis. Material and methods. The study groups included 21 patients with chronic allergic rhinitis, 20 patients with chronic vasomotor rhinitis, 9 patients with chronic atrophic rhinitis, 15 patients with chronic infectious rhinitis and 50 people from the control group. Diagnosis of chronic rhinitis, depending on the phenotype, taking into account the clinical recommendations of the Ministry of Health of Russia, was carried out by a doctor when the patient applied for treatment, followed by analysis of the data from a full range of instrumental examinations, clinical manifestations, anamnesis, and rhinoendoscopy results. 65 subjects with chronic rhinitis, as well as the control group, underwent a cytological examination of the nasal mucosa and an assessment of hematological parameters. Statistical analysis was carried out using the Statistica 10 package. Differences in groups were assessed using the nonparametric KruskalWallis test (for three or more comparison groups) and MannWhitney test (for pairwise comparison). The critical level of statistical significance in testing scientific hypotheses was p ˂0.05. Results. In chronic allergic rhinitis, three syndromes were locally identified: allergic syndrome (with a statistically significant increase in the absolute number of eosinophils up to 14 per field of view), non-specific inflammation syndrome (with a statistically significant increase in the number of leukocytes up to 9 per field of view) and a syndrome of protective changes in the nasal mucosa. At the same time, changes associated with allergic syndrome were recorded in the blood (with a statistically significant increase in the absolute number of eosinophils up to 0.84109/l). In chronic vasomotor rhinitis, changes in the nasal mucosa did not cause significant changes in the activity of blood cells. In chronic atrophic rhinitis, degenerative changes in the nasal mucosa (with a statistically significant decrease in the number of epithelial cells up to 2 per field of view; p14 0.001, p24 0.001) with local hemorrhagic syndrome were accompanied by the presence of statistically significant anemic (hemoglobin up to 109 g/l; p14 0.001, p24 0.001, p34 0.001, p45 0.001) and inflammatory syndromes in terms of blood parameters (with statistically significant leukocytosis up to 10109/l; p14 0.001, p24 0.001, p34 0.001). In chronic infectious rhinitis, local inflammatory syndrome with a statistically significant increase in the number of leukocytes up to 75 per field of view (p15 0.001, p25 0.001, p35 0.001, p45 0.001) with protective changes in the nasal mucosa confirmed by systemic inflammatory syndrome with statistically significant leukocytosis up to 12109/l (p15 0.001, p25 0.001, p35 0.001, p45=0.04), neutrophilic granulocytosis up to 9109/l (p15 0.001, p25 0.001, p35 0.001, p45=0.03) and an increase in the erythrocyte sedimentation rate up to 22 mm/h (p15 0.001, p25 0.001 , p35 0.001, p45 0.001) according to blood tests. Conclusion. The greatest number of local and systemic changes was found in chronic allergic and chronic infectious rhinitis, which requires increased attention to these diseases.
慢性鼻炎局部及全身指标的特点
的目标。慢性鼻炎局部及全身指标特征的研究。材料和方法。研究组包括慢性变应性鼻炎21例,慢性血管舒缩性鼻炎20例,慢性萎缩性鼻炎9例,慢性感染性鼻炎15例,对照组50例。考虑到俄罗斯卫生部的临床建议,在患者申请治疗时,医生根据表型对慢性鼻炎进行了诊断,随后分析了来自全方位仪器检查、临床表现、记忆和鼻内窥镜检查结果的数据。65名慢性鼻炎患者以及对照组接受了鼻黏膜细胞学检查和血液学参数评估。使用Statistica 10软件包进行统计分析。使用非参数KruskalWallis检验(用于三个或更多的对照组)和MannWhitney检验(用于两两比较)评估组间差异。检验科学假设的显著性水平为p小于0.05。结果。在慢性变应性鼻炎中,局部鉴定出三种综合征:过敏综合征(每视场内嗜酸性粒细胞绝对数量增加,有统计学意义,高达14个)、非特异性炎症综合征(白细胞数量增加,有统计学意义,高达9个)和鼻黏膜保护性改变综合征。同时,在血液中记录与过敏综合征相关的变化(嗜酸性粒细胞绝对数量增加,达到0.84109/l,具有统计学意义)。在慢性血管舒缩性鼻炎中,鼻黏膜的变化不会引起血细胞活性的显著变化。在慢性萎缩性鼻炎中,鼻黏膜的退行性改变(具有统计学意义的上皮细胞数量减少,每个视野最多减少2个;P14 0.001, p24 0.001)伴有局部出血性综合征的患者伴有有统计学意义的贫血(血红蛋白高达109 g/l;P14 0.001, p24 0.001, p34 0.001, p45 0.001)和炎症综合征在血液参数方面(白细胞高达10109/l,具有统计学意义;P14 0.001, p24 0.001, p34 0.001)。在慢性感染性鼻炎中,局部炎症综合征的白细胞数量有统计学意义的增加,每视野的白细胞数量高达75个(p15 0.001, p25 0.001, p35 0.001, p45 0.001),全身炎症综合征证实了鼻黏膜的保护性改变,白细胞计数有统计学意义的增加,高达12109/l (p15 0.001, p25 0.001, p35 0.001, p45=0.04),中性粒细胞计数高达9109/l (p15 0.001, p25 0.001, p35 0.001, p45 0.001),根据血液检查,红细胞沉降率增加至22毫米/小时(p15 0.001, p25 0.001, p35 0.001, P45 0.001)。结论。在慢性过敏性鼻炎和慢性感染性鼻炎中发现了最多的局部和全身改变,这需要增加对这些疾病的关注。
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