目的:对慢性鼻窦炎(CRS)与咽喉反流的关系进行初步探讨。方法:46例患者中,CRS伴鼻息肉患者25例(CRSwNP组),CRS不伴鼻息肉患者10例(CRSsNP组),11例因鼻腔解剖异常行手术治疗的患者作为对照组,采用免疫组织化学方法对3组标本的胃蛋白酶表达水平进行检测。将胃蛋白酶表达强度与鼻窦CT的Lund-Mackay评分、嗜酸粒细胞、淋巴细胞、单核细胞、嗜碱粒细胞、中性粒细胞进行相关性分析。结果:CRSwNP组胃蛋白酶表达强阳性8例(32%),阳性8例(32%),弱阳性2例(8%),阴性7例(28%)。CRSsNP组胃蛋白酶表达强阳性4例(40%),阳性3例(30%),弱阳性1例(10%),阴性2例(20%)。对照组胃蛋白酶表达强阳性0例,阳性2例(18.2%),弱阳性3例(27.3%),阴性6例(54.5%),CRSwNP组与CRSsNP组胃蛋白酶表达的强度高于对照组(P<0.05),CRSwNP组与CRSsNP组胃蛋白酶表达强度差异无统计学意义(P>0.05)。胃蛋白酶表达强度与Lund-Mackay评分存在正相关(r=0.349,P<0.05),与各种血炎性细胞百分比不存在直线相关关系。结论:咽喉反流与CRS存在相关性,可能是CRS的危险因素,咽喉反流与CRS严重程度呈正相关,咽喉反流引起CRS的炎症反应,并不以某种炎细胞为主。 Objective: To investigate the relationship between chronic sinusitis (CRS) and throat reflux. Methods: Twenty-five patients (CRSwNP group), CRS non-CRSsNP group (CRSsNP group), 11 patients with nasal dissection abnormalities were selected as the control group. Immunohistochemistry The chemical method was used to detect the pepsin expression level in three groups of specimens. The pepsin expression intensity was correlated with Lund-Mackay scores, eosinophils, lymphocytes, monocytes, basophils and neutrophils in sinus CT. Results: The expression of pepsin in CRSwNP group was strongly positive in 8 cases (32%), positive in 8 cases (32%), weakly positive in 2 cases (8%) and negative in 7 cases (28%). In the CRSsNP group, pepsin expression was strongly positive in 4 cases (40%), positive in 3 cases (30%), weakly positive in 1 case (10%) and negative in 2 cases (20%). In the control group, pepsin expression was strongly positive in 0 cases, positive in 2 cases (18.2%), weakly positive in 3 cases (27.3%) and negative in 6 cases (54.5%). The pepsin expression intensity in CRSwNP group and CRSsNP group was higher than that in control group P <0.05). There was no significant difference in pepsin expression between CRSwNP group and CRSsNP group (P> 0.05). There was a positive correlation between pepsin expression and Lund-Mackay score (r = 0.349, P <0.05), but there was no linear correlation between pepsin and various types of inflammatory cells. CONCLUSIONS: The correlation between throat reflux and CRS may be a risk factor for CRS. Throat reflux is positively correlated with the severity of CRS. Throat reflux may cause inflammation of CRS and not inflammatory cells.