变应性鼻炎患者血清PTX3,LXA4表达水平及临床价值研究  

Serum PTX3 and LXA4 Levels in Patients with Allergic Rhinitis and Their Clinical Significance

作　　者：吴莉芳[1] 张麟[1] 张杰[2] 王占军[1] WU Li-fang;ZHANG Lin;ZHANG Jie;WANG Zhan-jun(Department of Otolaryngology Head and Neck Surgery,the Fifth People’s Hospital of Datong,Shanxi Datong 037000,China;Department of Otolaryngology,Medical College of Datong University,Shanxi Datong 037000,China)

机构地区：[1]大同市第五人民医院耳鼻咽喉头颈外科,山西大同037000 [2]大同大学医学院耳鼻咽喉科教研室,山西大同037000

出　　处：《现代检验医学杂志》2023年第2期140-145,共6页Journal of Modern Laboratory Medicine

摘　　要：目的分析变应性鼻炎(allergic rhinitis,AR)患者血清正五聚蛋白3(pentraxin 3,PTX3)和脂氧素A4(lipoxin A4,LXA4)水平及临床意义。方法选取2019年6月~2022年6月80例大同市第五人民医院已确诊收治的AR患者为AR组,其中轻度AR 27例、中度AR 23例和重度AR 30例。同期在该院体检的健康者90例为对照组。酶联免疫吸附法(enzyme linked immunosorbent assay,ELISA)检测血清中PTX3和LXA4水平;用Pearson法分析AR患者血清PTX3与LXA4表达相关性,以及PTX3,LXA4与过敏性鼻炎评分量表(score for allergic rhinitis,SFAR)评分的相关性;绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析PTX3,LXA4对AR的诊断价值;采用logistic回归分析中重度AR发生的影响因素。结果AR组血清PTX3(22.62±2.57ng/ml)和LXA4(60.81±6.33nmol/L)水平明显高于对照组(17.81±2.56ng/ml,54.83±6.24nmol/L),差异具有统计学意义(t=12.205,6.195,均P<0.001)。中度、重度AR组血清PTX3(21.13±1.78,26.42±3.57ng/ml)和LXA4水平(59.87±6.34,66.54±7.13nmol/L)明显高于轻度AR组(19.69±2.14ng/ml,55.23±5.42nmol/L),差异具有统计学意义(F=76.181,22.762,均P<0.001)。PTX3和LXA4高表达组病情程度为中、重度,SFAR评分≥7分,IgE阳性患者所占比例高于病情程度为轻度、SFAR评分<7分,IgE阴性患者,差异具有统计学意义(χ^(2)=6.265,4.059,5.485,10.908,8.038,11.077,均P<0.05);Pearson相关性分析显示,AR患者血清PTX3与LXA4表达水平呈显著正相关(r=0.592,P<0.001),PTX3,LXA4与SFAR评分呈显著正相关(r=0.617,0.843,均P<0.001)。ROC曲线分析显示,血清PTX3诊断AR发生的AUC,敏感度和特异度分别为0.916(95%CI=0.863~0.953),80.00%,90.00%;LXA4诊断AR发生的AUC,敏感度和特异度分别为0.705(95%CI=0.630~0.772),86.25%,46.67%;两者联合诊断的AUC,敏感度和特异度分别为0.938(95%CI=0.890~0.969)93.75%,90.00%。Logistic回归分析表明,SFAR评分(OR=1.617,95%CI=1.256~2.082)、PTX3(OR=1.537,95%CI=1.152~2.050)和LXA4(OR=1.463,95%CI=1.125~1.9Objective To analyze the levels and clinical significance of serum pentraxin 3(PTX3)and lipoxin A4(LXA4)in patients with allergic rhinitis(AR).Methods From June 2019 to June 2022,80 AR patients diagnosed and admitted to the Fifth People’s Hospital of Datong were regarded as AR group,including 27 cases of mild AR,23 cases of moderate AR,and 30 cases of severe AR.Meantime,90 healthy people who underwent physical examination in the hospital were the control group.The levels of PTX3 and LXA4 in serum were detected by ELISA.Pearson method was used to analyze the correlation between the expressions of serum PTX3 and LXA4 in AR patients,and the correlation between PTX3,LXA4 and the score for allergic rhinitis(SFAR).ROC curve was used to analyze the diagnostic value of PTX3 and LXA4 for AR and logistic regression was used to analyze the influencing factors of moderate to severe AR.Results The levels of serum PTX3(22.62±2.57 ng/ml)and LXA4(60.81±6.33 nmol/L)in AR group were significantly higher than those in control group(17.81±2.56 ng/ml,54.83±6.24 nmol/L),and the differences were statistically significant(t=12.205,6.195,all P<0.001).The levels of serum PTX3(21.13±1.78,26.42±3.57 ng/ml)and LXA4(59.87±6.34,66.54±7.13 nmol/L)in moderate and severe AR groups were significantly higher than those in mild AR group(19.69±2.14 ng/ml,55.23±5.42nmol/L),and the difference was statistically significant(F=76.181,22.762,all P<0.001).The proportions of patients with moderate to severe disease,SFAR score≥7 points,and IgE positive in PTX3 and LXA4 high expression group were greatly higher than those in patients with mild disease,SFAR score<7 points,and IgE negative(χ^(2)=6.265,4.059,5.485,10.908,8.038,11.077,all P<0.05).Pearson correlation analysis showed that the expression levels of serum PTX3 and LXA4 in AR patients were greatly positively correlated(r=0.592,P<0.001),and PTX3,LXA4 and SFAR scores were greatly positively correlated(r=0.617,0.843,all P<0.001).The ROC curve results showed that the AUC of serum PTX3 in the

关 键 词：变应性鼻炎 正五聚蛋白3 脂氧素A4 

分 类 号：R765.21[医药卫生—耳鼻咽喉科] R392.11[医药卫生—临床医学]