中文摘要：

目的比较鼻窦CT与其他临床指标对于嗜酸粒细胞性慢性鼻-鼻窦炎（ CRS）伴鼻息肉（eosinophilic chronic rhinosinusitis with nasal polyps ，eCRSwNP）的预诊断价值。方法2016年1—5月连续入组150例于北京同仁医院耳鼻咽喉头颈外科住院的CRS伴鼻息肉患者（90例eCRSwNP，60例非嗜酸粒细胞性CRS伴鼻息肉），记录所有患者的年龄、性别、既往史等基本特征。所有患者在接受内镜鼻窦手术治疗前1周，均进行鼻窦CT检查、变应原皮肤点刺试验、呼出一氧化氮浓度测量以及外周血常规检查。用t检验和χ^2检验比较两组间患者的年龄、性别分布、手术史、哮喘史、过敏史、筛窦与上颌窦评分比值、骨质增生出现率以及窦口扩张出现率；用Mann-Whitney分析比较两组间患者的CT总分、呼出一氧化氮浓度及嗜酸粒细胞计数；用Logistic回归分析及受试者工作特征曲线对各临床指标在eCRSwNP的预诊断价值方面进行比较。结果 eCRSwNP患者的筛窦与上颌窦评分比值、呼出一氧化氮浓度、外周血嗜酸粒细胞百分比均显著高于非嗜酸粒细胞性CRS伴鼻息肉患者[3.56±0.37比1.80±0.10，（34.4±18.1）μg／L比（22.1±11.7）μg／L，8.19％±1.50％比4.55％±5.60％，χ^2值为0.900，t值分别为0.994、0.900，P值均〈0.05]。在CT评分方面，筛窦与上颌窦评分比值具有最高的预测诊断价值，其曲线下面积为0.938。当筛窦与上颌窦评分比值的截断值〉2.59时，其敏感度和特异度分别为94.3％和89.6％。结论与其他诊断指标相比，筛窦与上颌窦评分比值对于eCRSwNP有更高的预测诊断价值。

英文摘要：

Objective To compare the value of sinonasal CT scan with other clinical parameters in the pre-diagnosis of eosinophilic chronic rhinosinusitis with nasal polyps （ eCRSwNP ）.Methods From January to May of 2016, One hundred and fifty consecutive CRSwNP patients （90 eCRSwNP and 60 non-eosinophilic CRSwNP ） undergoing endoscopic functional sinus surgery in Beijing Tongren Hospital were recruited in this study.Preoperative CT scan ,skin prick test （ SPT） and oral fractional exhaled nitric oxide （ FeNO） measurements were performed in each patient and full blood count with differential analysis was＆amp;nbsp;performed within 1 week before surgery.t test and X2 test were used to compare the age , gender , history of surgery , onset of asthma , history of allergy , CT scores＆#39;ratio for the ethmoid sinus and maxillary sinus （ E/M ratio） and presence of osteoneogenesis of two groups.Mann-Whitney analysis was used to compare the total Lund-Mackay scores , FeNO and blood eosinophil counts of two groups.Logistic regression analysis and receiver operating characteristic （ ROC ） curve were used to assess the predictive value of clinical parameters.Results E/M ratio, FeNO, blood eosinophil percentage of eCRSwNP group was significantly higher than those of non-eosinophilic CRSwNP group [3.56 ±0.37 vs 1.80 ±0.10, （34.4 ±18.1） μg/L vs （22.1 ±11.7） μg/L, 8.19%±1.50%vs 4.55%±5.60%;χ^2 value was 0.900;t value was 0.994 and 0.900, respectively; all P〈0.05].E/M ratio had the highest predictive value , with area under curve （ AUC） value of 0.938.The cut-off point of 2.59 for E/M ratio demonstrated a sensitivity of 94.3%and a specificity of 89.6%for eCRSwNP.Conclusion The E/M ratio is a more useful predictor in the diagnosis of eCRSwNP compared to other clinical parameters.