外周血嗜酸性粒细胞预测过敏性鼻炎舌下免疫治疗效果的价值

Value of peripheral blood eosinophils in predicting the therapeutic effect of sublingual specific immunotherapy in patients with allergic rhinitis

目的研究外周血嗜酸性粒细胞(EOS)在过敏性鼻炎(AR)舌下特异性免疫治疗(SLIT)效果预测中的价值。方法对2018年1月至2020年6月在东莞康华医院200例接受SLIT的AR患者治疗前症状及治疗后6个月症状进行评分,根据症状总评分的改善情况进行疗效评价;分析疗效与治疗前外周血EOS计数及外周血EOS百分比的相关性,并对这两个指标在预测SLIT疗效中的价值进行评估。结果200例接受SLIT的AR患者,坚持完成6个月疗程的患者178例,其中有效126例,无效52例,有效率70.8%;治疗前外周血EOS计数及外周血EOS百分比与SLIT的疗效有微弱的相关性(r=0.168,P=0.048;r=0.250,P=0.001);根据外周血EOS计数及百分比与SLIT疗效的关系制作受试者工作特征曲线(ROC),外周血EOS计数曲线下面积为0.380,外周血EOS百分比为0.355,均<0.5,无诊断价值。结论治疗前外周血EOS计数及外周血EOS百分比与SLIT疗效无明显的相关性,对SLIT的疗效预测价值有限。

Objective To investigate the value of peripheral blood eosinophils(EOS)in predicting the therapeutic effect of sublingual specific immunotherapy(SLIT)in patients with allergic rhinitis(AR).Methods From January 2018 to June 2020,200 patients with AR who received SLIT in Dongguan Kanghua Hospital were evaluated for their symptoms before treatment and 6 months after treatment.The curative effect was evaluated according to the improvement of the total symptom score.The number of eosinophils,percentage of eosinophils in peripheral blood were measured before treatment.The correlation between curative effect and EOS count and EOS percentage was analyzed and the value of these two indicators in predicting the efficacy of SLIT was evaluated.Results Of the 200 AR patients,178 patients were confirmed to have completed the treatment course of 6months.126 effective and 52 ineffective,the effective rates were 70.8%.There was a weak correlation between the number of EOS in peripheral blood and the percentage of EOS in peripheral blood before treatment and the efficacy of SLIT(r=0.168,P=0.048;r=0.250,P=0.001).The area under the curve of peripheral blood EOS count was 0.380,and the percentage of peripheral blood EOS was 0.355,which were all less than 0.5.Conclusions There was no significant correlation between the number of peripheral blood EOS count and peripheral blood EOS percentage and the efficacy of SLIT,therefore,both of blood EOS count and blood EOS percentage have no value in predicting the efficacy of SLIT.