Correlation between clinical features of asthma and computed tomographic findings of nose and maxillary sinus
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気管支喘息26症例において喘息の臨床的特徴と,鼻腔･上顎洞のCT所見の関連について検討を加えた｡1.鼻腔粘膜肥厚はアトピー症例,非アトピー症例間で有意な差は認められなかった｡上顎洞における粘膜肥厚比率(1slice上の上顎洞面積に対し,上顎洞粘膜が占める割合)も,アトピー･非アトピーで差は認められなかった｡2.ステロイド依存群･非依存群においても,鼻腔粘膜肥厚･上顎洞粘膜肥厚に有意な差は認められなかった｡3.アスピリン喘息症例においては,非アスピリン喘息症例に比べ,上顎洞粘膜肥厚が顕著であったが有意ではなかった｡鼻腔粘膜肥厚は2群間で差は認められなかった｡4.発作時の一日喀痰量との関連では一日喀痰量が100mℓ以上の症例群では,喀痰量が50mℓ以下の群･50-100mℓの群に比較して有意に上顎洞粘膜肥厚比率が高値を示した｡鼻腔粘膜比率に関しては3群間で有意な差を認めなかった｡以上の結果から,喀痰量の多い気管支喘息症例では,その病態に副鼻腔病変が影響を及ぼしている可能性が考えられ,副鼻腔病変に対する治療により,気管支喘息が改善する可能性が考えられた｡Extent of nasal and maxillary mucosa lesion was estimated in 26 asthmatics using computed tomographic scan in relation to clinical features of the disease. 1. Nosignificant differences were present in nasal mucosal thickening between atopic and non-atopic subjects. No significant differences were also present in occupancy rate of mucosa in maxillary sinuses between the two asthma types. 2. Nasal mucosal thickening was not significant different between subjects with steroid-dependentintractable asthma (SDIA) and those without SDIA. Maxillary mucosal lesions were more extensive in subjects with SDIA than in those without SOIA. However, nosignificant differences were observed in occupancy rate between the two types. 3. No significant differences were observed in nasal mucosal thickenings between in subjectswith and without aspirin-induced asthma (AlA). Although maxillary mucosa lesion in subjects with AlA was more extensive than that in those without AlA, the differenceswas not significant. 4. There was not any correlation between nasal mucosal thickening and amount of expectoration per day. However, significant differences were observed in maxillary sinus lesion between subjects with less amount (<50mℓ/day) and those with large amount of expectoration (100mℓ/day≦)(p<0.002), and betweensubjects with moderate amount (50-99mℓ/ day) and those with large amount of expectoration (p<0.002). The results might suggest that in asthmatics with large amount of expectoration, sinus diseases affect pathophysiology of asthma, and asthmatics with large amount of expectoration should have therapy for sinus disease to improve asthmatic status.
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