慢性鼻窦炎患儿血清LTB4、NLRC4水平变化及对术后复发的预测价值  

Changes of serum LTB4 and NLRC4 levels in children with chronic rhinosinusitis and their predictive value for postoperative recurrence

作　　者：寿艳玲 罗三利[1] 胡玉莲[1] SHOU Yanling;LUO Sanli;HU Yulian(Department of Pediatric Rehabilitation,Zhengzhou Maternal and Child Health Hospital,Zhengzhou 450012,Henan,China)

机构地区：[1]河南省郑州市妇幼保健院儿童康复科,河南郑州450012

出　　处：《右江医学》2024年第7期634-640,共7页Chinese Youjiang Medical Journal

摘　　要：目的探究慢性鼻窦炎(CRS)患儿血清白三烯B4(LTB4)、Nod样受体家族蛋白4(NLRC4)水平变化及其临床意义。方法2020年1月至2021年10月选取接受鼻窦内窥镜治疗的184例CRS患儿(CRS组),根据术后3个月预后分为复发组与未复发组。另以同期100例体检健康儿童作为对照(NC)组。酶联免疫吸附法检测血清LTB4、NLRC4水平,比较各组血清LTB4、NLRC4水平。分析CRS组患儿在术前以及术后1周、4周、8周视觉模拟量表(VAS)评分、Lund-Kennedy评分及血清LTB4、NLRC4水平变化。采用Pearson法分析血清LTB4与NLRC4水平的相关性。多因素logistic回归分析CRS患儿术后复发的可能影响因素。受试者工作特征(ROC)曲线分析术前血清LTB4、NLRC4对术后复发的预测价值。结果CRS组患儿血清LTB4水平为(62.85±13.17)pg/mL、NLRC4水平为(759.82±108.46)pg/mL,NC组的血清LTB4水平为(17.43±4.08)pg/mL、NLRC4水平为(203.75±36.93)pg/mL,两组比较差异均有统计学意义(P<0.001)。相关性分析显示,CRS组血清LTB4与NLRC4水平呈正相关性(r=0.638,P<0.001)。血清LTB4水平、NLRC4水平与CRS患儿年龄、性别、是否伴有鼻息肉无关(P>0.05)。术前、术后1周、术后4周、术后8周VAS评分、Lund-Kennedy评分及血清LTB4、NLRC4水平依次下降(P<0.05)。复发组术前血清LTB4水平为(77.62±15.85)pg/mL、NLRC4水平为(860.39±126.92)pg/mL,显著高于未复发组的(57.78±12.25)pg/mL、(725.32±102.13)pg/mL,差异有统计学意义(P<0.001)。多因素logistic回归分析结果显示,术前血清LTB4、NLRC4水平均是CRS患儿复发的危险因素(OR=2.114,95%CI=1.129~3.958;OR=1.883,95%CI=1.190~2.979)(P<0.05或0.01)。NLRC4、LTB4及二者联合预测术后复发的曲线下面积(AUC)分别为0.839、0.824、0.913。结论慢性鼻窦炎患儿血清LTB4、NLRC4表达水平升高,且与预后密切相关,两者联合有望成为慢性鼻窦炎术后复发的早期预测指标。Objective To investigate the changes and clinical significance of serum leukotriene B4(LTB4)and Nod-like receptor C4(NLRC4)levels in children with chronic rhinosinusitis(CRS).Methods A total of 184 children with CRS(CRS group)who received endoscopic sinus therapy in hospital from January 2020 to October 2021 were gathered and grouped into recurrence group and non-recurrence group according to 3-month postoperative prognosis.Another 100 healthy children with physical examination were selected as normal control(NC)group.The serum levels of LTB4 and NLRC4 were detected by enzyme-linked immunosorbent assay,and the serum levels of LTB4 and NLRC4 were compared among groups.The visual analogue scale(VAS)scores,Lund-Kennedy scores and the changes of serum levels of LTB4 and NLRC4 before operation and at 1 week,4 weeks and 8 weeks after operation in the CRS group were analyzed.Pearson method was used to analyze correlation between serum LTB4 and NLRC4 levels.Multivariate logistic regression analysis was carried out on possible influencing factors for postoperative recurrence in children with CRS.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of preoperative serum LTB4 and NLRC4 for postoperative recurrence.Results The serum LTB4 and NLRC4 levels in the CRS group were(62.85±13.17)pg/mL and(759.82±108.46)pg/mL,respectively,and those in the NC group were(17.43±4.08)pg/mL and(203.75±36.93)pg/mL,respectively,so difference between the two groups was statistically significant(P<0.001).Correlation analysis showed that serum LTB4 levels were positively correlated with NLRC4 levels in the CRS group(r=0.638,P<0.001).Serum LTB4 levels and NLRC4 levels were not associated with age,gender,and nasal polyps in children with CRS(P>0.05).The VAS score,Lund-Kennedy score,and serum LTB4 and NLRC4 levels sequentially decreased before surgery,at 1 week after surgery,4 weeks after surgery,and 8 weeks after surgery(P<0.05).The preoperative serum LTB4 and NLRC4 levels in the recurrence group were(77.62±1

关 键 词：慢性鼻窦炎 鼻窦内窥镜 白三烯B4 Nod样受体家族蛋白4 预后 

分 类 号：R726.5[医药卫生—儿科]