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目的:比较不同内在型慢性鼻窦炎伴鼻息肉(CRSwNP)患者的临床特征及外周血炎性介质的表达水平,探寻和内在型关联的外周血生物标志物。方法:纳入2015年1月至2017年12月于华中科技大学同济医学院附属同济医院行鼻内镜手术的74例CRSwNP患者,其中男41例,女33例,平均年龄40岁;另纳入40例鼻中隔偏曲患者作为对照组。术前记录患者的年龄、性别、既往史等基本特征以及鼻部症状视觉模拟量表(VAS)评分、CT评分等临床特征。根据鼻息肉组织标本嗜酸粒细胞(Eos)百分比及中性粒细胞(Neu)计数将CRSwNP患者分为高嗜酸高中性(Eosn highNeun high)、高嗜酸低中性(Eosn highNeun low)、低嗜酸高中性(Eosn lowNeun high)及低嗜酸低中性(Eosn lowNeun low)4种内在型。采用Bio-Plex悬浮芯片法检测外周血血清中27个常见的炎性介质的表达水平。比较不同内在型CRSwNP患者的人口学和临床特征,以及外周血血清炎性介质的表达水平。采用SPSS 18.0软件进行统计学分析。n 结果:Eosn highNeun high、Eosn highNeun low、Eosn lowNeun high及Eosn lowNeun low CRSwNP患者在性别比例、年龄、病程、鼻部症状VAS评分、内镜及CT评分方面的差异均无统计学意义。Eosn highNeun high以及Eosn highNeun low CRSwNP患者的特应性体质比例、哮喘和变应性鼻炎合并率、外周血嗜酸粒细胞绝对值及百分比均显著高于Eosn lowNeun high和Eosn lowNeun low CRSwNP组(n P值均0.05)。n 结论:尽管Eosn high和Eosn low CRSwNP患者在特应性体质比例、哮喘和变应性鼻炎合并率、外周血嗜酸粒细胞绝对值及百分比方面有显著差异,但临床特征、外周血细胞以及炎性介质不能有效区分4种不同内在型的CRSwNP,需进一步寻找客观、方便、可靠、与内在型关联的生物标志物。n “,”Objective:To compare the clinical characteristics and plasma inflammatory markers levels in different endotypes of chronic rhinosinusitis with nasal polyps (CRSwNP), and to explore the plasma biomarkers associated with endotypes of CRSwNP.Methods:A total of 74 CRSwNP patients (male/female: 41/33; average age: 40 years) and 40 control subjects underwent septoplasty in Tongji Hospital from January 2015 to December 2017 were enrolled in this study. The demographic and clinical features of all subjects including age, gender, past history, visual analogue scale (VAS) and CT scores were recorded. Patients with CRSwNP were divided into Eosn highNeun high, Eosn highNeun low, Eosn lowNeun high and Eosn lowNeun low four endotypes according to the eosinophil (Eos) percentage and neutrophil (Neu) count of nasal polyps tissue. Preoperative blood routine was performed and the levels of 27 biomarkers in plasma were measured by Bio-Plex suspension chip method. The clinical characteristics and the level of serum biomarkers of patients with different endotypes were compared. SPSS 18.0 software was used for statistical analysis.n Results:There was no difference in the clinical features including gender ratio, age, course of disease, VAS score, endoscopy and CT score among Eosn highNeun high, Eosn highNeun low, Eosn lowNeun high and Eosn lowNeun low CRSwNP patients. Compared with Eosn lowNeun high and Eosn lowNeun low CRSwNP patients, patients with Eosn highNeun high and Eosn highNeun low endotype demonstrated a higher prevalence of atopy, allergic rhinitis and asthma comorbidity, and increased peripheral blood eosinophil absolute count and percentage (all n P0.05).n Conclusions:Eosn high and Eosn low CRSwNP patients display significant differences regarding the prevalence of atopy, allergic rhinitis and asthma comorbidity, peripheral blood eosinophil absolute count and percentage, but the clinical characteristics, blood cellular and biological markers can not effectively distinguish four endotypes of CRSwNP. Further studies are warranted to dig out the potential objective, convenient and reliable markers associated with endotypes in patients with CRSwNP.n