摘要
目的研究外周血及组织嗜酸粒细胞(Eos)对慢性鼻-鼻窦炎伴鼻息肉(CRSw NP)术后复发的预测价值。方法选取接受治疗的CRSw NP患者235例,根据术后复发情况分为复发组和未复发组,比较两组的临床资料,采用苏木精-伊红染色法观察鼻息肉标本中炎性细胞数量,采用logistic多因素回归分析CRSw NP复发相关因素,采用ROC曲线分析Eos对CRSw NP患者术后复发的预测价值。结果随访结果显示:CRSw NP术后复发131例(55.74%),未复发104例(44.26%)。复发组的哮喘发生率、嗅觉损失评分、头/面痛评分、流涕评分、Lund-Mackay评分均明显高于未复发组(χ2=10.61,t分别=28.04、3.94、2.86、6.23,P均<0.05);复发组患者组织及外周血中Eos比例明显高于未复发组,外周血及组织中的Neu、淋巴细胞及组织浆细胞比例明显低于未复发组(Z分别=9.13、6.48、5.27、5.37、8.72、4.33、4.33,P均<0.05);logistic回归分析,组织Eos增多和哮喘史是疾病复发的危险因素(OR分别=1.37、5.41,P均<0.05);ROC曲线分析结果显示:当组织Eos百分比取5.45时,其预测CRSw NP术后鼻息肉复发的AUC面积为0.96(95%CI:0.94~0.98),特异度为78.60%,灵敏度为98.10%。结论组织Eos增多能够预测CRSw NP术后复发的情况,当组织Eos百分比取5.45时,其预测CRSw NP术后复发的灵敏度及特异度最为理想,可作为临床预测该疾病复发的标准。
Objective To observe the predictive value of eosinophils（Eos）of peripheral blood and tissue in the recurrence of chronic rhinosinusitis with nasal polyps（CRSw N）.Methods Totally 235 cases of CRSw N were selected and divided into recurrent group and non recurrent group according to the postoperative recurrence. The number of inflammatory cells in CRSw N specimen was observed by HE staining,and the factors associated with CRSw N recurrence were analyzed by logistic regression analysis.The predictive value of Eos for postoperative recurrence of CRSw NP patients was analyzed by ROC curve. Results The follow-up results showed that 131 cases（55.74%）were enrolled in the recurrence group and 104 cases（44.26%）were enrolled in the non recurrent group.The incidence rate of asthma,olfactory loss score,head/face pain score,snivel score and Lund-Mackay score of recurrent group were significantly higher than those of non-recurrent group（χ2=10.61,t=28.04,3.94,2.86,6.23,P〈0.05）. The proportions of Eos in tissues and peripheral blood of recurrent patients was significantly higher than those of non-recurrence patients,while the proportions of Neu,lymphocytes in tissues and peripheral blood and plasmacytes in tissue of recurrent patients were significantly lower than those of non-recurrent patients（Z=9.13,6.48,5.27,5.37,8.72,4.33,4.33,P〈0.05）. Logistic regression analysis showed that the increased proportion of Eos and asthma were risk factors for disease recurrence（OR=1.37,5.41,P〈0.0,5）.When the cut-off value of tissue Eos was 5.45,the area of AUC for predicting the recurrence of nasal polyps after CRSw N was 0.96（95% CI：0.94~0.98）,the specificity was 78.60% and the sensitivity was 98.10%.Conclusion Increased proportion of tissue Eos can predict the recurrence of CRSw N.When the percentage of tissue Eos is 5.45,the sensitivity and specificity for predicting the recurrence of CRSw N is the best. It can be used as a clinical standard for predicting the recurrence of CRSw N.
作者
徐征
邹玉华
张舒
XU Zheng ,Z0U Yuhiia, ZHANG Shu(Department of ENT, Taizhou First People’s Hospital,Taizhou 318020,Chin)
出处
《全科医学临床与教育》
2018年第5期524-527,共4页
Clinical Education of General Practice
关键词
嗜酸粒细胞百分比
预测价值
鼻息肉复发
慢性鼻-鼻窦炎
eosinophil percentage
predictive value
recurrence of nasal polyps
chronic rhinosinusitis
