| 刘 妮,高 英,王 丽,刘 涛,杨 慧.慢性鼻窦炎伴鼻息肉患者血清OPN、BAFF、25-（OH）D3的变化及对息肉组织分型的鉴别价值探讨[J].,2022,(19):3790-3795 |
| 慢性鼻窦炎伴鼻息肉患者血清OPN、BAFF、25-（OH）D3的变化及对息肉组织分型的鉴别价值探讨 |
| Changes of Serum OPN, BAFF, and 25-(OH)D3 in Patients with Chronic Rhinosinusitis with Nasal Polyps and its Differential Value Discussion for Polyp Tissue Typing |
| 投稿时间：2022-04-20 修订日期：2022-05-16 |
| DOI：10.13241/j.cnki.pmb.2022.19.038 |
| 中文关键词: 慢性鼻窦炎 鼻息肉 OPN BAFF 25-（OH）D3 鉴别价值 |
| 英文关键词: Chronic rhinosinusitis Nasal polyps OPN BAFF 25-(OH)D3 Differential value |
| 基金项目:陕西省重点研发计划项目（2022JM-551） |
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| 中文摘要: |
| 摘要 目的：探讨慢性鼻窦炎伴鼻息肉（CRSwNP）患者血清骨桥蛋白（OPN）、B细胞活化因子（BAFF）、25羟基维生素D3[25-（OH）D3]水平及其对息肉组织分型的鉴别价值。方法：选取2019年6月-2021年6月于延安大学附属医院治疗的87例CRSwNP患者为CRSwNP组，根据息肉组织嗜酸粒细胞浸润程度将其分为嗜酸性CRSwNP患者（ECRSwNP组，n=41）和非嗜酸性CRSwNP患者（nECRSwNP组，n=46）。选取同期于延安大学附属医院治疗的慢性鼻窦炎不伴鼻息肉患者（CRSsNP组，n=60）和健康体检者（对照组，n=60）。比较CRSwNP组、CRSsNP组和对照组患者血清OPN、BAFF、25-（OH）D3水平。采用多因素Logistic回归分析ECRSwNP发生的影响因素，采用受试者工作特征（ROC）曲线评估各指标对CRSwNP息肉组织分型的鉴别价值。结果：CRSwNP组、CRSsNP组血清OPN、BAFF水平高于对照组，25-（OH）D3水平低于对照组，且CRSwNP组血清OPN、BAFF水平高于CRSsNP组，25-（OH）D3水平低于CRSsNP组（P<0.05）。ECRSwNP组变应性鼻炎史、哮喘病史患者占比、外周血嗜酸粒细胞数量及比例、血清总IgE浓度、血清OPN及BAFF水平高于nECRSwNP组（P<0.05），而血清25-（OH）D3水平低于nECRSwNP组（P<0.05）。多因素Logistic回归分析显示：外周血嗜酸粒细胞数量及比例、血清总IgE浓度、血清OPN及BAFF水平升高是ECRSwNP发生的危险因素（P<0.05），25-（OH）D3水平升高是ECRSwNP的保护因素（P<0.05）。血清OPN、BAFF、25-（OH）D3对CRSwNP息肉组织分型单独检测的ROC曲线下面积（AUC）分别为：0.789、0.800、0.817，联合检测鉴别CRSwNP患者息肉组织分型的AUC为0.900，灵敏度、特异度分别为0.860、0.827，联合检测鉴别价值更高（P＜0.05）。结论：血清OPN、BAFF和25-（OH）D3水平在不同息肉组织分型中具有差异性，CRSwNP患者血清OPN和BAFF水平升高是ECRSwNP发生的危险因素，25-（OH）D3水平升高是保护因素，联合检测辅助临床鉴别CRSwNP息肉组织类型的价值更高。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the levels of serum osteopontin (OPN), B cell activation factor (BAFF) and 25 hydroxyvitamin D3 [(25-(OH)D3)] in patients with chronic rhinosinusitis with nasal polyps (CRSsNP) and its value in differentiation of polyp tissue typing. Methods: A total of 87 patients with CRSwNP who were treated in Affiliated Hospital of Yan'an University from June 2019 to June 2021 were selected as the CRSwNP group, and they were divided into eosinophilic CRSwNP patients (ECRSwNP group, n=41) and non-eosinophilic CRSwNP patients (nECRSwNP group, n=46) according to the degree of eosinophilic infiltration of polyps. Patients with chronic sinusitis without nasal polyps (CRSsNP group, n=60) and healthy subjects (control group, n=60) who were treated in Affiliated Hospital of Yan'an University during the same period were selected. The levels of serum OPN, BAFF and 25-(OH)D3 in CRSwNP group, CRSsNP group and control group were compared. Multivariate Logistic regression was used to analyze the influencing factors of the occurrence of ECRSwNP, and receiver operating characteristic (ROC) curve was used to evaluate the differential value of each index for CRSwNP polyp tissue typing. Results: The levels of serum OPN and BAFF in CRSwNP group and CRSsNP group were higher than those in control group, and the level of 25-(OH)D3 was lower than that in control group, and the levels of serum OPN and BAFF in CRSwNP group were higher than those in CRSsNP group, and the level of 25-(OH)D3 was lower than that in CRSsNP group (P<0.05). The proportion of patients with history of allergic rhinitis and asthma, the number and proportion of peripheral blood eosinophils, serum total IgE concentration, levels of OPN and BAFF in ECRSwNP group were higher than those in nECRSwNP group (P<0.05), while the level of serum 25-(OH)D3 was lower than that in nECRSwNP group (P<0.05). Multivariate Logistic regression analysis showed that the number and proportion of peripheral blood eosinophils, serum total IgE concentration, and serum OPN and BAFF levels increased were the risk factors for ECRSwNP (P<0.05), while the level of 25-(OH)D3 was the protective factor for ECRSwNP (P<0.05). The ROC area under curve (AUC) of serum OPN, BAFF and 25-(OH)D3 for CRSwNP polyp tissue typing were as follows: 0.789, 0.800, 0.817, the AUC of combined detection to identify polyp tissue typing in patients with CRSwNP was 0.900, the sensitivity and specificity were 0.860, 0.827, respectively, and the combined detection had higher discrimination value (P<0.05). Conclusion: The levels of serum OPN, BAFF and 25-(OH)D3 are different in different polyp tissue typing. Increased levels of serum OPN and BAFF are risk factors for ECRSwNP in patients with CRSwNP, and increased levels of 25-(OH)D3 are protective factors. Combined detection is of higher value in clinical identification of CRSwNP polyp tissue typing. |
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