慢性鼻窦炎伴鼻息肉患者术后复发影响因素及血清ECP、IL-21对复发的预测价值  

Identify the influencing factors of postoperative recurrence in patients with chronic sinusitis and nasal polyps and the predictive value of serum ECP and IL-21

作　　者：王荣霞[1] 尹会文 张薇薇 王秋菊 刘文霞[1] WANG Rongxia;YIN Huiwen;ZHANG Weiwei;WANG Qiuju;LIU Wenxia(Hengshui Second People's Hospital,Hebei 053000,China)

机构地区：[1]衡水市第二人民医院,河北衡水053000

出　　处：《中国实验诊断学》2024年第11期1280-1285,共6页Chinese Journal of Laboratory Diagnosis

摘　　要：目的 探讨慢性鼻窦炎伴鼻息肉患者术后复发的影响因素及血清嗜酸性粒细胞阳离子蛋白(ECP)和白细胞介素-21(IL-21)水平对复发的预测价值,寻找评价慢性鼻窦炎伴鼻息肉术后复发的有效生物学标志物。方法 选取2019年12月至2020年10月衡水市第二人民医院收治的107例接受手术治疗的慢性鼻窦炎伴鼻息肉患者为研究对象,采集患者手术前后静脉血,ImmunoCAP 100~(TM)过敏原检测系统检测血清ECP水平,通过酶联免疫吸附法检测血清IL-21水平,对患者进行随访,随访终点为复发,统计患者术后2年复发情况,分析影响慢性鼻窦炎伴鼻息肉患者术后复发的独立因素,分析ECP、IL-21水平对慢性鼻窦炎伴鼻息肉患者术后复发的预测价值。结果 截止随访结束失访3例,剩余104例患者中术后2年有27例出现复发,其余77例患者未复发,复发组鼻窦CT评分高于未复发组,差异有统计学意义(P<0.05)。治疗前,复发组CD8^(+)T淋巴细胞比例高于未复发组,CD4^(+)/CD8^(+)值低于未复发组,治疗后,复发组CD4^(+)T淋巴细胞比例与CD4^(+)/CD8^(+)值低于未复发组,CD8^(+) T淋巴细胞比例高于未复发组,差异有统计学意义(P<0.05)。治疗前和治疗后,复发组的IgE、CCL4、ECP及IL-21水平均高于未复发组,差异有统计学意义(P<0.05)。Logistic多因素回归分析显示鼻窦CT积分、治疗前ECP、IL-21及治疗后ECP、IL-21是慢性鼻窦炎伴鼻息肉患者术后复发的独立影响因素(P<0.05)。ROC曲线显示鼻窦CT评分、治疗前ECP、IL-21,治疗后ECP、IL-21对术后复发均有预测价值(P<0.05且AUC>0.500),其中治疗前ECP、IL-21联合鼻窦CT评分预测术后复发的最佳敏感度和特异度分别为0.825、0.806,治疗后ECP、IL-21联合鼻窦CT评分预测术后复发的最佳敏感度和特异度分别为0.954、0.633。结论 鼻窦积分、治疗前后的ECP、IL-21水平对慢性鼻窦炎伴鼻息肉患者术后复发均有较高的预测价值,可以�Objective To explore the influencing factors of postoperative recurrence in patients with chronic sinusitis complicated and nasal polyp;To assess the predictive value of serum eosinophilic cationic protein(ECP) and interleukin-21(IL-21) levels for recurrence as well, aim to search an effective biomarker for evaluation of chronic sinusitis complicated with nasal polyp recurrence.Methods A total of 107 patients with chronic sinusitis and nasal polyps who underwent surgery and were admitted to the Second People's Hospital of Hengshui from December 2019 to October 2020 were selected as the research objects.Preoperative venous blood was collected from the patients before and after surgery, and the serum eosinophil cationic protein level was detected by the ImmunoCAP 100^(TM) allergen detection system, and serum IL-21 level was detected by enzyme-linked immunosorbent assay.the patients were followed up, the end point of follow-up was recurrence, the recurrence of patients was counted 2 years after surgery, and the impact on patients with chronic sinusitis and nasal polyps was analyzed.The factors of postoperative recurrence were analyzed to observe the relationship between serum eosinophil cationic protein and IL-21 levels and postoperative recurrence in patients with chronic sinusitis and nasal polyps.Results A total of 3 cases were lost to follow-up by the end of the follow-up period.Among the remaining 104 patients, 27 cases relapsed 2 years after the operation, and the remaining 77 cases did not relapse, and the sinus CT scores in the recurrent group were higher than those in the non-recurrent group, and the differences were statistically significant(P<0.05).Before treatment, the proportion of CD8^(+)T lymphocytes in the recurrent group was higher than that of the non-recurrence group, the value of CD4^(+)/CD8^(+) was lower than that of the non-recurrence group, and after treatment, the proportion of CD4-T lymphocytes in the relapse group was lower than that of the non-recurrence group, and the difference was stati

关 键 词：慢性鼻窦炎 鼻息肉 嗜酸性粒细胞阳离子蛋白 白细胞介素-21 预后 

分 类 号：R765.4[医药卫生—耳鼻咽喉科]