外周血嗜酸粒细胞诊断嗜酸粒细胞性慢性鼻-鼻窦炎的分析评价

Evaluation of blood eosinophil in the diagnosis of eosinophilic chronic rhinosinusitis

目的 分析评价外周血嗜酸粒细胞（EOS）诊断EOS性慢性鼻-鼻窦炎（CRS）的临床实用性.方法 回顾性分析2013年1月至2015年6月就诊于温州医科大学附属第一医院的787例CRS患者的临床资料,分析血EOS计数与百分比与组织中EOS计数与百分比的相关性,寻找血EOS计数或百分比的截断值并比较其诊断EOS性CRS的能力.以SPSS 19.0软件进行统计学分析.结果 787例CRS患者血EOS计数及其百分比与组织EOS计数及其百分比均呈正相关（r值分别为0.450、0.449;0.463、0.465,P值均＜0.01）;在分别控制血白细胞和组织EOS炎症程度后血EOS计数与组织EOS计数和百分比的相关性均消失（r=0.041,P=0.380;r=0.046,P=0.329和r=0.023,P=0.618;r =0.032,P=0.499）;而血EOS百分比与组织EOS计数和百分比的相关性则不同程度降低（r值分别为0.383、0.436;0.153、0.169,P值均＜0.01）.外周血EOS计数和百分比诊断EOS性CRS的截断值随EOS性CRS的组织学诊断标准的不同而不同.结论 外周血EOS与组织EOS浸润呈正相关,但相关强度不高,且可能受个体因素影响较大,虽然其诊断EOS性CRS在理论上可行,但临床实用性可能有限.

Objective To evaluate the practice of peripheral blood eosinophil in the diagnosis of eosinophilic chronic rhinosinusitis （ECRS）.Methods The correlation between eosinophil count and percentage in peripheral blood and that in topic tissue in 787 patients （the first affiliated hospital of Wenzhou medical university,from Jan.2013 to Jun.2016） with chronic rhinosinusitis （CRS） were retrospectively analysed.The optimal cutoff value of blood eosinophil count and percentage as predictors for ECRS was determined by receiver operating characteristic curves （ROC） and their diagnostic ability was compared.Results The positive correlation between eosinophil count and percentage in blood and that in tissue was found respectively in 787 patients with CRS （r =0.450,0.499,0.463,0.465,P 〈 0.01）.Although the significant correlation between blood eosinophil count and its count and percentage in tissue was not found after blood leukocyte and tissue eosinophilic inflammation was controlled respectively （r =0.041,P =0.380;r =0.046,P =0.329 and r =0.023,P=0.618;r =0.032,P =0.499）,blood eosinophil percentage still showed significant correlation with tissue eosinophil count and percentage,but reduced unequally after that（r =0.383,0.436 and r =0.153,0.169,P 〈0.01）.With ROC analysis,the diagnostic ability of optimal cut off values of eosinophil count and percentage varied as the histological criteria for ECRS differed.Conclusions Eosinophil in peripheral blood showed significant positive correlation with its tissue infiltration,which may be not strong and easily effected by individual factors.Theoretically,blood eosinophil may have a diagnostic significance as a predictor for ECRS but not practically.