非变应性鼻炎伴嗜酸粒细胞增多综合征患儿鼻腔分泌物细胞学检查的临床意义  

Analysis of diagnostic efficacy and evaluation of ventilatory function in cytological examination of nasal secretions in NARES

作　　者：李朝晖 张建辉 陈玉芝 何金萍 马爱民 Li Zhaohui;Zhang Jianhui;Chen Yuzhi;He Jinping;Ma Aimin(Department of Otolaryngology,North China Petroleum General Hospital,Hebei Renqiu 062552,China;Department of Pediatric,North China Petroleum General Hospital,Hebei Renqiu 062552,China;Department of Pathology,North China Petroleum General Hospital,Hebei Renqiu 062552,China)

机构地区：[1]华北石油总医院耳鼻咽喉头颈外科,河北任丘062552 [2]华北石油总医院儿科,河北任丘062552 [3]华北石油总医院病理科,河北任丘062552

出　　处：《中国医刊》2020年第6期628-632,共5页Chinese Journal of Medicine

摘　　要：目的分析非变应性鼻炎伴嗜酸粒细胞增多综合征(nonallergic rhinitis with eosinophilia syndrome,NARES)患儿鼻腔分泌物细胞学检查的诊断效能及鼻腔通气功能的评估价值。方法选取2017年10月至2019年10月华北石油总医院收治的80例NARES患儿作为观察组,另选取同期50名健康体检小儿作为对照组,两组均进行鼻腔分泌物细胞学检查、皮肤点刺实验(skin prick test,SPT)和鼻腔通气功能测量,并记录患儿鼻部症状视觉模拟量表(visual analogue scale,VAS)评分。结果观察组鼻腔分泌物嗜酸性粒细胞计数及细胞因子干扰素-γ(interferon-γ,IFN-γ)、白细胞介素(interleukin,IL)-4、IL-10、IL-17水平明显高于对照组,收缩前75Pa和150Pa下鼻腔总阻力值明显高于对照组,差异均有显著性(P<0.05),但收缩后75Pa和150Pa下鼻腔总阻力值与对照组比较差异无显著性(P>0.05)。收缩前后两组鼻声反射最小横截面积比较差异均无显著性(P>0.05)。以SPT实验结果为标准,鼻腔分泌物细胞学检查的阳性符合率为92.19%,阴性符合率为90.91%,总符合率为91.54%。相关分析显示,NARES患儿鼻腔通气功能指标下鼻腔总阻力值、鼻声反射最小横截面积与鼻部各主观症状VAS评分的相关性系数r均小于0.5,差异无显著性(P>0.05)。结论鼻腔分泌物细胞学检查对小儿NARES的诊断效能较高,但鼻腔通气功能与患儿的主观症状没有明显相关性,无评估价值,因此在诊断过程中要充分结合主客观结果,以降低临床漏诊率和误诊率。Objective To analyze the diagnostic efficacy and evaluation of ventilatory function of nasal secretion cytology in children with non-allergic rhinitis and eosinophilic hyperplasia(NARES).Method Eighty children with NARES admitted to our hospital from October 2017 to October 2019 were selected as observation group,and 50 healthy children with physical examination were selected as the control group.All patients were examined for nasal secretion cytology,skin prick test and Nasal ventilation function was measured,and the visual analog scale(VAS)score of the nasal symptoms was recorded,followed by statistical analysis.Result There were significant differences in the eosinophil counts between the two groups and the levels of cytokines IFN-γ,IL-4,IL-10 and IL-17(P<0.05).There was a statistically significant difference in the total nasal resistance(TNR)between the two groups before the contraction at 75 Pa and 150 Pa(P<0.05),but there was no statistical difference(P>0.05)between the 75 and 150 Pa nasal contractions(P>0.05).There was no statistically significant difference in the minimum cross-sectional area(MCA)between the nasal and nasal nasal reflexes(P>0.05).Comparing the results of SPT experiment,the positive coincidence rate of nasal secretion cytology was 92.19%,the negative coincidence rate was 90.91%,and the total coincidence rate was 91.54%.Correlation analysis showed that the correlation coefficient r of the total nasal resistance value,the minimum cross-sectional area of nasal acoustic reflex and the VAS score of each nasal subjective symptom under the nasal ventilation function index of NARES children was less than 0.5,and the difference was not significant(P>0.05).Conclusion Cystic examination of nasal secretions has a higher diagnostic efficiency for children with non-allergic rhinitis with eosinophilia,but nasal ventilation function has no correlation with subjective symptoms and has no evaluation value.Therefore,the diagnosis process should be fully integrated with the subjective and objective The resul

关 键 词：非变应性鼻炎伴嗜酸粒细胞增多综合征 小儿 鼻腔分泌物 细胞学检查 通气功能 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]