变应性鼻炎局部炎症客观指标初探  

A preliminary study on the biomarkers of local inflammation in allergic rhinitis

作　　者：祝婉婷 余文婷 高培 张启迪 周玥 王彦君[1] 陈建军[1] ZHU Wanting;YU Wenting;GAO Pei;ZHANG Qidi;ZHOU Yue;WANG Yanjun;CHEN Jianjun(Department of Otolaryngology Head and Neck Surgery,Union Hospital of Tongji Medical College,Huazhong University of Science and Technology,Wuhan,430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院耳鼻咽喉头颈外科,武汉430022

出　　处：《临床耳鼻咽喉头颈外科杂志》2021年第4期306-311,315,共7页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：国家自然科学基金项目(No:81570898,81873693)。

摘　　要：目的:探索鼻分泌物中可以辅助诊断变应性鼻炎(AR)以及可用于临床治疗效果评估参考的客观标志物。方法:纳入33例AR患者(AR组)和21例健康对照者(健康对照组)。收集健康对照及AR患者治疗前后的鼻分泌物,检测鼻细胞学、细胞因子(IL-5、IL-6、IL-8、IL-33、IFN-γ)和炎症因子(ECP、MPO)的浓度,比较健康对照及AR患者治疗前后各指标的差异。分析各指标/各指标差值/各指标差值百分比与临床症状评分/评分差值/评分差值百分比的相关性。结果:与健康对照组比较,AR组治疗前鼻分泌中的ECP、IL-5、IL-6、IL-8、IL-33和IFN-γ均升高(P<0.05),MPO未见明显差异;治疗后,AR患者鼻分泌物中的ECP显著下降(P<0.01),炎症细胞等级及嗜酸粒细胞百分比下降(P<0.01),但MPO、IL-5、IL-6、IL-8、IL-33和IFN-γ均未见明显改变。治疗前后ECP差值与VAS差值具有相关性(r=0.348,P=0.047);IL-5差值与VAS差值(r=0.406,P=0.019)和流涕差值(r=0.429,P=0.013)具有相关性;鼻分泌物嗜酸粒细胞百分比差值与鼻塞差值具有相关性(r=0.383,P=0.028);嗜酸粒细胞百分比与分级乘积差值与VAS评分(r=0.417,P=0.016)和鼻塞差值(r=0.519,P=0.002)具有相关性;IFN-γ差值百分比与VAS评分/流涕/喷嚏/鼻部总评分差值百分比具有相关性。结论:鼻分泌物中ECP、IL-6、IL-8、IL-33因子有望成为辅助诊断AR的客观指标,其中ECP、IL-5、IFN-γ、嗜酸粒细胞百分比与分级乘积有望成为判断患者治疗后症状改善的客观指标。Objective: This study aimed to explore the biomarkers in nasal secretion that can assist in the diagnosis of allergic rhinitis(AR) and can be used to evaluate the therapeutic effect of AR. Methods: Thirty-three patients with AR and 21 healthy controls were included. The nasal secretion of healthy controls and patients with AR(before and after treatment) were collected. The cytology, the concentrations of cytokines(IL-5, IL-6, IL-8, IL-33, IFN-γ) and inflammatory mediators(ECP, MPO) were detected. Then, we compared the differences of various biomarkers between healthy controls and AR patients(before and after treatment group). And analyzed the correlation between each biomarkers/biomarkers difference value/the percentage of biomarkers difference value and clinical symptom score/score difference value/the percentage of score difference value. Results: Compared with normal controls, the levels of ECP, IL-5, IL-6, IL-8, IL-33 and IFN-γ in nasal secretion of AR patients were significantly higher than those of normal controls(P<0.05). There was no significant difference in MPO. After treatment, ECP decreased significantly(P<0.01), inflammatory cell grade and eosinophil percentage are also decreased(P<0.01). However, MPO, IL-5, IL-6, IL-8, IL-33 and IFN-γ did not change significantly. The difference value of ECP before and after treatment was correlated with the difference value of VAS score(r=0.348, P=0.047). The difference value of IL-5 was correlated with the difference value of VAS score and rhinorrhea, the correlation coefficients were 0.406(P=0.019) and 0.429(P=0.013), respectively. The difference value of eosinophil percentage in nasal secretion before and after treatment was correlated with nasal congestion, and the correlation coefficient was 0.383. The difference value of eosinophil percentage multiplied by inflammatory cell grade before and after treatment was correlated with VAS score(r=0.417, P=0.016) and nasal congestion difference value(r=0.519, P=0.002). The percentage of difference value of IFN-γ be

关 键 词：鼻炎 变应性 细胞因子 炎症因子 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]