上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2019, Vol. 39 ›› Issue (8): 903-.doi: 10.3969/j.issn.1674-8115.2019.08.016

• 论著·临床研究 • 上一篇    下一篇

嗜酸粒细胞性慢性鼻 -鼻窦炎临床预测诊断指标的对比研究

李婷，李吉平   

  1. 上海交通大学医学院附属仁济医院耳鼻喉科，上海 200120
  • 出版日期:2019-08-28 发布日期:2019-09-23
  • 通讯作者: 李吉平，电子信箱：drlijiping@163.com。
  • 作者简介:李婷（1992—），女，硕士生；电子信箱： 1325547043@qq.com。

Comparison of clinical indexes in predicting eosinophilic chronic rhinosinusitis

LI Ting, LI Ji-ping   

  1. Department of Otolaryngology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200120, China
  • Online:2019-08-28 Published:2019-09-23

PDF (PC)

477

摘要： 目的 ·在同一体系中比较嗜酸粒细胞性慢性鼻 -鼻窦炎（ eosinophilic chronic rhinosinusitis，ECRS）预测诊断的临床评估指标。方法 ·回顾性分析于上海交通大学医学院附属仁济医院行内镜下鼻腔鼻窦开放手术的 89例慢性鼻 -鼻窦炎患者的临床特征。以术中所取组织病理检查结果为金标准，诊断 ECRS患者 35例，非 ECRS（non-ECRS）患者 54例。分别比较 2组患者外周血嗜酸性粒细胞（ eosinophil，EOS）绝对值、外周血 EOS百分比（ EOS%）、E/M比值（筛窦与上颌窦 Lund-Mackay评分比值）和日本难治性鼻窦炎流行病学调查研究协会（ Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis，JESREC）评分。用受试者工作特征曲线（ receiver operating characteristic curve，ROC曲线）来比较各预测指标的优劣。结果 · ① ECRS患者的外周血 EOS绝对值、外周血 EOS%、E/M比值和 JESREC评分显著高于 non-ECRS患者（均 P<0.01）。② JESREC评分的 ROC曲线下面积（area under curve，AUC）为 0.893，外周血 EOS%的 AUC为 0.877，外周血 EOS绝对值的 AUC为 0.870，E/M比值的 AUC为 0.724。结论 ·①采取 JESREC评分、外周血 EOS%、外周血 EOS绝对值、E/M比值这些临床指标对于 ECRS均有一定的预测诊断价值。②同一体系中比较，JESREC评分、外周血 EOS%、外周血 EOS绝对值具有较高的预测效率。

关键词: 慢性鼻 -鼻窦炎, 诊断, 嗜酸性粒细胞, JESREC评分, E/M比值

Abstract:

Objective · To evaluate clinical indexes in predicting eosinophilic chronic rhinosinusitis (ECRS) in the one system. Methods · In this retrospective study, 89 chronic rhinosinusitis patients who underwent endoscopic sinus surgery in Renji Hospital, Shanghai Jiao Tong University School of Medicine were studied. Thirty-five patients were diagnosed as having ECRS, 54 having non-ECRS according to pathology. Peripheral blood eosinophil (EOS) absolute counts, peripheral blood EOS percentages (EOS%), E/M ratios (Lund-Mackay score ratio of ethmoid sinus to maxillary sinus) and Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis (JESREC) scores were compared between the two groups. Receiver operating characteristic curves were constructed to assess the advantages and disadvantages of each predictive diagnostic index. Results · ① The peripheral blood EOS absolute and percentage, E/M ratio and JESREC score were higher in ECRS group than those in non-ECRS (P<0.01). ② AUC value of JESREC score was 0.893, peripheral blood EOS% was 0.877, peripheral blood EOS absolute was 0.870, and E/M ratio was 0.724. Conclusion · ① JESREC score, peripheral blood EOS absolute and percentage, and E/M ratio can be applied to predict ECRS. ② JESREC score, peripheral blood EOSabsoluteand peripheral blood EOS%show higherpredictingefficiency.

Key words: chronic rhinosinusitis, diagnose, eosinophil, JESREC score, E/M ratio

中图分类号: