血清总IgE联合嗜酸性粒细胞对不同年龄阶段变应性鼻炎的诊断价值  

Diagnostic value of total serum IgE levels combined with eosinophils in allergic rhinitis at different ages

作　　者：谷悦 沈暘[1] 熊攀辉 官大宇 卢韬 杨玉成[1] GU Yue;SHEN Yang;XIONG Panhui;GUAN Dayu;LU Tao;YANG Yucheng(Department of Otolaryngology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院耳鼻咽喉科,重庆400016

出　　处：《新医学》2024年第10期779-786,共8页Journal of New Medicine

基　　金：国家自然科学基金(81970864)。

摘　　要：目的探讨血清总免疫球蛋白E(IgE)、嗜酸性粒细胞(EOS)及其百分比在不同年龄阶段的变应性鼻炎(AR)诊断价值,并构建血清总IgE联合EOS初步诊断AR的诊断模型。方法回顾性分析2023年4月至2024年4月就诊于重庆医科大学附属第一医院耳鼻咽喉科305例AR患者、256例非AR患者的临床资料,比较2组患者一般资料、血清总IgE水平、EOS计数及其百分比之间的差异,用二元Logistic回归分析筛选合适指标构建诊断模型,并绘制受试者操作特征(ROC)曲线,以曲线下面积(AUC)来判断模型的诊断价值。收集2019年6月至2022年6月就诊于重庆医科大学附属第一医院耳鼻咽喉科AR及非AR患者共216例资料,进行外部验证。根据年龄分组[青少年组(≤18岁)、青年组(19~45岁)、中年组(46~60岁)、老年组(>60岁)]进行分层分析。结果总体以及各年龄组均显示EOS百分比及总IgE为AR的影响因素,所有患者联合诊断模型:Logit P=-4.174+6.856EOS计数+0.048总IgE;青少年组诊断模型:Logit P=-4.472+0.637EOS百分比+0.034总IgE;青年组诊断模型:Logit P=-4.491+0.372EOS百分比+0.068总IgE;中年组诊断模型:Logit P=-4.759+5.768EOS计数+0.062总IgE;老年组诊断模型:Logit P=-4.888+0.855EOS百分比+0.028总IgE。Hosmer-Lemeshow拟合优度检验、ROC曲线分析、外部验证均显示了上述模型具有较高的诊断价值。结论血清总IgE水平联合EOS对不同年龄段AR具有良好诊断价值,可用于指导AR初步诊断。Objective To evaluate the diagnostic value of total serum immunoglobulin E(IgE)levels,eosinophil(EOS)count and percentage in the diagnosis of allergic rhinitis(AR),and to construct a diagnostic model for preliminary diagnosis of AR by combining total serum IgE and EOS.Methods Clinical data of 305 AR patients and 256 non-AR patients admitted to Department of Otolaryngology at the First Affiliated Hospital of Chongqing Medical University from April 2023 to April 2024 were retrospectively analyzed.The general information,total serum IgE level,EOS count and percentage were compared between two groups.Binary logistic regression analysis was used to screen for suitable indicators to construct the predictive model,and the receiver operating characteristic(ROC)curve was plotted.The area under the ROC curve(AUC)was used to determine the predictive value of this model.Clinical data from 216 patients with and without AR admitted to Department of Otolaryngology at the First Affiliated Hospital of Chongqing Medical University from June 2019 to June 2022 were collected for external validation.Stratification analysis was performed according to age[adolescent group(≤18 years old),youth group(19-45 years old),middle-aged group(46-60 years old),and elderly group(>60 years old)],respectively.Results The percentage of EOS and total serum IgE level were the influencing factors of AR in the overall and all age groups.The combined diagnostic model for all patients was:Logit P=-4.174+6.856EOS count+0.048total serum IgE.Diagnostic model in adolescent group was:Logit P=-4.472+0.637EOS percentage+0.034total serum IgE;youth group:Logit P=-4.491+0.372EOS percentage+0.068total serum IgE;middle-aged group:Logit P=-4.759+5.768EOS count+0.062total serum IgE;elderly group:Logit P=-4.888+0.855EOS percentage+0.028total serum IgE,respectively.Hosmer-Lemeshow goodness-of-fit test,ROC curve analysis and external validation all indicated that this model had high diagnostic value.Conclusion The combination of total serum IgE levels and EOS count demon

关 键 词：变应性鼻炎 免疫球蛋白E 嗜酸性粒细胞 诊断价值 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]