Features of local and systemic indicators in chronic rhinitis

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 Kruskal–Wallis test (for three or more comparison groups) and Mann–Whitney 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 0.84×10⁹/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; p1–4 <0.001, p2–4 <0.001) with local hemorrhagic syndrome were accompanied by the presence of statistically significant anemic (hemoglobin up to 10⁹ g/l; p1–4 <0.001, p2–4 <0.001, p3–4 <0.001, p4–5 <0.001) and inflammatory syndromes in terms of blood parameters (with statistically significant leukocytosis up to 10×10⁹/l; p1–4 <0.001, p2–4 <0.001, p3–4 <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 (p1–5 <0.001, p2–5 <0.001, p3–5 <0.001, p4–5 <0.001) with protective changes in the nasal mucosa confirmed by systemic inflammatory syndrome with statistically significant leukocytosis up to 12×10⁹/l (p1–5 <0.001, p2–5 <0.001, p3–5 <0.001, p4–5=0.04), neutrophilic granulocytosis up to 9×10⁹/l (p1–5 <0.001, p2–5 <0.001, p3–5 <0.001, p4–5=0.03) and an increase in the erythrocyte sedimentation rate up to 22 mm/h (p1–5 <0.001, p2–5 <0.001 , p3–5 <0.001, p4–5 <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.