过敏性鼻炎舌下免疫治疗效果与外周血嗜酸性粒细胞、血清总IgE水平的相关性研究

Study of correlation between the effect of sublingual immunotherapy and peripheral blood eosinophils and total serum IgE level in allergic rhinitis

目的研究过敏性鼻炎(AR)舌下免疫治疗(SLIT)效果与外周血嗜酸性粒细胞(EOS)、血清总IgE(TIgE)水平的相关性,旨在探讨AR患者治疗前外周血EOS及血清TIgE水平在预测SLIT疗效中的价值。方法共纳入200例接受SLIT治疗的AR患者,坚持完成18个月疗程的患者有167例,采用Spearman相关性分析法分析167例AR患者疗效欠佳、治疗前血清TIgE水平、外周血EOS计数、外周血EOS百分比的相关性,并分析治疗前外周血TIgE水平、EOS计数及EOS百分比预测SLIT疗效欠佳的灵敏度、特异度、准确度、阳性预测值(PPV)、阴性预测值(NPV)、假阳性率、假阴性率。结果接受SLIT治疗的AR患者疗效欠佳与血清TIgE水平无明显相关(r=0.082,P=0.630);疗效欠佳与治疗前外周血EOS计数及外周血EOS百分比呈中度相关(r=0.605、0.723,P=0.029、0.008)。治疗前外周血血清TIgE水平、EOS计数、EOS百分比预测SLIT疗效欠佳时的灵敏度、特异度、准确度、PPV、NPV、假阳性率、假阴性率相差非常大,三个指标均不理想。结论AR患者SLIT疗效欠佳与治疗前血清TIgE水平无关,而与外周血EOS计数及EOS百分比有一定的相关性,但外周血EOS计数及EOS百分比能否作为AR患者SLIT疗效欠佳的预测指标,尚有待于进一步研究。

Objective To study the correlation between the effect of sublingual immunotherapy(SLIT)and peripheral blood eosinophils(EOS)and total serum IgE(TIgE)level in allergic rhinitis(AR),and explore the value of peripheral blood EOS and serum TIgE level before treatment in predicting the efficacy of SLIT in AR patients.Methods A total of 200 patients with AR who received SLIT therapy were included,and 167 patients insisted on completing the 18 month course of treatment.Spearman correlation analysis method was used to analyze the correlation of poor curative effect,serum TIgE level,peripheral blood EOS count and peripheral blood EOS percentage before treatment in 167 AR patients,and the sensitivity,specificity,accuracy,positive predictive value(PPV),negative predictive value(NPV),false positive rate and false negative rate of predicting the poor curative effect of SLIT by the peripheral blood TIgE level,EOS count and EOS percentage before treatment were analyzed.Results There was no significant correlation between the poor curative effect of AR patients treated with SLIT and serum TIgE level(r=0.082,P=0.630);there were moderate correlation between the poor curative effect and the peripheral blood EOS count and the peripheral blood EOS percentage before treatment(r=0.605,0.723,P=0.029,0.008).The sensitivity,specificity,accuracy,PPV,NPV,false positive rate and false negative rate of serum TIgE level,EOS count and EOS percentage in peripheral blood before treatment were significantly different in predicting the poor curative effect of AR,and all three indexes were not ideal.Conclusion The poor curative effect of SLIT in AR patients is not related to serum TIgE level before treatment,but to some extent correlated with peripheral blood EOS count and EOS percentage.However,whether peripheral blood EOS count and EOS percentage can be used as a predictive indexes of the poor curative effect of SLIT in AR patients remains to be further studied.