文章摘要
谈齐峰,贾金文,雍 军,艾尼·艾海提,艾日法特·艾尼瓦尔.嗜酸性粒细胞、调节性T细胞对慢性鼻窦炎伴鼻息肉的诊断及预后预测价值分析[J].,2023,(19):3630-3635
嗜酸性粒细胞、调节性T细胞对慢性鼻窦炎伴鼻息肉的诊断及预后预测价值分析
Analysis of the Diagnostic and Prognostic Value of Eosinophils and Regulatory T Cells in Chronic Sinusitis with Nasal Polyps
投稿时间:2023-06-06  修订日期:2023-06-30
DOI:10.13241/j.cnki.pmb.2023.19.006
中文关键词: 嗜酸性粒细胞  调节性T细胞  慢性鼻窦炎伴鼻息肉  诊断效能  预后预测
英文关键词: Eosinophils  Regulatory T cells  Chronic sinusitis with nasal polyps  Diagnostic effectiveness  Prognostic prediction
基金项目:新疆维吾尔自治区自然科学基金项目(2021D01A53)
作者单位E-mail
谈齐峰 新疆医科大学第五附属医院耳鼻喉科 新疆 乌鲁木齐 830011 tanqifeng159357@163.com 
贾金文 新疆医科大学第五附属医院耳鼻喉科 新疆 乌鲁木齐 830011  
雍 军 新疆医科大学第一附属医院耳鼻喉科 新疆 乌鲁木齐 830054  
艾尼·艾海提 新疆医科大学第五附属医院耳鼻喉科 新疆 乌鲁木齐 830011  
艾日法特·艾尼瓦尔 新疆医科大学第五附属医院耳鼻喉科 新疆 乌鲁木齐 830011  
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中文摘要:
      摘要 目的:探讨嗜酸性粒细胞、调节性T细胞对慢性鼻窦炎伴鼻息肉的诊断及预后预测价值。方法:选取我院2020年3月到2023年3月收治的100例慢性鼻窦炎伴鼻息肉患者作为研究对象,将其分为慢性鼻窦炎伴鼻息肉组,选取同期来我院治疗的100例单纯慢性鼻窦炎患者作为慢性鼻窦炎组,另选取同期来我院体检的100名健康志愿者作为对照组。对比三组受检者嗜酸性粒细胞、调节性T细胞表达水平,并建立受试者工作特征(ROC)曲线,分析嗜酸性粒细胞、调节性T细胞对慢性鼻窦炎伴鼻息肉的诊断效能。随后对100例性鼻窦炎伴鼻息肉患者手术治疗后进行1年随访,依照患者的复发情况评价其预后情况,并分为两个亚组,将术后1年内复发的21例患者分为预后不良组,两未复发的79例患者分为预后良好组,对比两组患者一般临床情况,嗜酸性粒细胞、调节性T细胞表达水平,并分析嗜酸性粒细胞、调节性T细胞对慢性鼻窦炎伴鼻息肉的预后预测价值。结果:三组受检者嗜酸性粒细胞、调节性T细胞表达水平对比差异显著,慢性鼻窦炎伴鼻息肉组患者嗜酸性粒细胞(EOS)个数高于慢性鼻窦炎组和对照组,调节性T细胞(Tregs)水平低于慢性鼻窦炎组和对照组(P<0.05);通过绘制ROC曲线,确定EOS、Tregs其对慢性鼻窦炎伴鼻息肉的诊断效能,结果显示,EOS、Tregs两者联合对慢性鼻窦炎伴鼻息肉的诊断效能优于单一检测(P<0.05);预后良好组与预后不良组患者性别、年龄、BMI、吸烟史、饮酒史、白细胞介素-35(IL-35)、转化生长因子-β(TGF-β)、白细胞介素-1β(IL-1β)表达水平对比无明显差异(P>0.05),预后良好组与预后不良组患者病程、合并哮喘、合并变应性鼻炎、组织淋巴细胞占比、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)、EOS个数以及Tregs表达水平对比差异显著(P<0.05);logistic回归分析结果表明:合并哮喘、组织淋巴细胞占比、EOS个数以及Tregs为慢性鼻窦炎伴鼻息肉的预后独立影响因素(P<0.05)。结论:嗜酸性粒细胞、调节性T细胞不仅对慢性鼻窦炎伴鼻息肉的临床诊断具有重要价值,而且能够预测慢性鼻窦炎伴鼻息肉患者的预后情况,因此临床上对于EOS个数增加,Tregs降低的患者要及时改善治疗措施,预防患者预后不良的发生。
英文摘要:
      ABSTRACT Objective: To explore the diagnostic and prognostic value of eosinophils and regulatory T cells in chronic sinusitis with nasal polyps. Methods: 100 patients with chronic sinusitis and nasal polyps admitted to our hospital from March 2020 to March 2023 were selected as the research subjects. They were divided into the chronic sinusitis and nasal polyps group, 100 patients with simple chronic sinusitis who came to our hospital for treatment during the same period were selected as the chronic sinusitis group, and 100 healthy volunteers who came to our hospital for physical examination during the same period were selected as the control group. Compare the expression levels of eosinophils and regulatory T cells among three groups of subjects, and establish receiver operating characteristic (ROC) curves to analyze the diagnostic efficacy of eosinophils and regulatory T cells in chronic sinusitis with nasal polyps. Subsequently, 100 patients with sinusitis and nasal polyps were followed up for 1 year after surgical treatment. The prognosis was evaluated based on the recurrence of the patients and divided into two subgroups. 21 patients who recurred within 1 year after surgery were divided into a poor prognosis group, and 79 patients who did not recur were divided into a good prognosis group. The general clinical situation, expression levels of eosinophils and regulatory T cells in the two groups were compared, and the expression levels of eosinophils and regulatory T cells were analyzed The prognostic predictive value of regulatory T cells in chronic sinusitis with nasal polyps. Results: The number of eosinophils (EOS) was higher in the chronic sinusitis with nasal polyps group than in the chronic sinusitis group and the control group, and the level of regulatory T cells (Tregs) was lower than in the chronic sinusitis group and the control group (P<0.05); the diagnostic efficacy of EOS and Tregs on chronic sinusitis with nasal polyps was determined by plotting ROC curves. The diagnostic efficacy of EOS and Tregs on chronic sinusitis with nasal polyps was determined by plotting ROC curves, and the results showed that the combination of EOS and Tregs was more effective than a single test in the diagnosis of chronic sinusitis with nasal polyps(P<0.05); There was no significant difference between the good prognosis group and the poor prognosis group in terms of gender, age, BMI, smoking history, alcohol consumption history, interleukin-35 (IL-35), transforming growth factor-β (TGF-β), and interleukin-1β (IL-1β) expression levels (P>0.05). The differences in disease duration, combined asthma, combined allergic rhinitis, tissue lymphocyte percentage, interleukin-10 (IL-10), tumor necrosis factor-α(TNF-α), number of EOS, and Tregs expression levels between the good prognosis group and the poor prognosis group were significant(P<0.05); Logistic regression analysis showed that combined asthma, tissue lymphocyte percentage, number of EOS, and Tregs were independent factors influencing the prognosis of chronic sinusitis with nasal polyps(P<0.05). Conclusion: Eosinophils and regulatory T cells not only have important value in the clinical diagnosis of chronic sinusitis with nasal polyps, but also can predict the prognosis of patients with chronic sinusitis with nasal polyps. Therefore, in clinical practice, patients with an increase in EOS and a decrease in Tregs should promptly improve treatment measures to prevent the occurrence of poor prognosis.
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