血液和鼻分泌物中嗜酸粒细胞和嗜酸粒细胞阳离子蛋白对变应性鼻炎的辅助诊断价值

The diagnostic value of eosinophilic and eosinophilic cationic proteins in blood and nasal secretions for allergic rhinitis

目的:对比分析血液和鼻分泌物中嗜酸粒细胞和嗜酸粒细胞阳离子蛋白(ECP)对变应性鼻炎(AR)的辅助诊断价值。方法:选取33例AR患者(AR组)和40例健康正常人(对照组)的血液样本,检测血浆中ECP含量和全血中嗜酸粒细胞百分比;同时选取2组的鼻分泌物样本并检测其中ECP含量和嗜酸粒细胞百分比。利用受试者工作特征曲线计算各指标的截止值和有用性,并分析各指标与临床症状评分之间的相关性。结果:与对照组相比,AR患者的血浆ECP、全血嗜酸粒细胞百分比、鼻分泌物ECP和鼻分泌物嗜酸粒细胞百分比均明显升高(P<0.001)。鼻分泌物中ECP的曲线下面积(AUG)为0.965 9,当截断值为3.634时,可获得100%的灵敏度和88%的特异性;鼻分泌物嗜酸粒细胞百分比的AUG为0.863 6,当截断值为0.72时,可获得100%的灵敏度和73%的特异性;全血嗜酸粒细胞百分比的AUG为0.908 7,当截断值取4.6时,可获得95%的灵敏度和73%的特异性;血浆ECP的AUG为0.903,当截断值为0.866时,可获得90%的灵敏度和76%的特异性。结论:鼻分泌物ECP对于AR具有最佳的预测能力,鼻分泌物嗜酸粒细胞百分比具有较好的特异性,是理想的辅助诊断指标。

Objective: To compare the diagnostic value of eosinophil and eosinophil cationin protein(ECP) in blood and nasal secretions for allergic rhinitis(AR). Method: Collecting the blood samples of 33 patients with AR(AR group) and 40 healthy people(control group), and test the concentration of ECP in serum and the percentage of eosinophil in blood. At the same time, collecting the nasal secretions samples of 33 patients with AR and 24 healthy people, and test the concentration of ECP and the percentage of eosinophils in nasal secretions. Using receiver operating characteristic curve(ROC) analysis, calculate the area under the curve(AUC) for each parameter and determine their predictive capabilities, then analyzing the correlation between each indicator and clinical symptom scores. Result: Compared with the healthy control group, the concentration of ECP and the percentage of eosinophil in blood and nasal secretion increased significantly(P<0.001) in patients with AR. The AUG of ECP concentration in nasal secretions was 0.965 9, when the cut-off value was 3.634, 100% sensitivity and 88% specificity were obtained;the AUG of eosinophil percentage in blood was 0.9087, and when its cut-off value was 4.6, 95% sensitivity and 73% specificity were obtained;the ECP concentration in serum had an AUG of 0.903, and when the cut-off value was 0.866, 90% sensitivity and 76% specificity were obtained;the AUG of nasal secretion eosinophil’s percentage was 0.863 6, when its cut-off value is 0.72, 100% sensitivity and 73% specificity were obtained. Conclusion: For allergic rhinitis, ECP concentrate in nasal secretions is the ideal auxiliary diagnosis marker, and has the best predictive capability.