外周血EOS、NLR联合检测诊断慢性鼻-鼻窦炎价值分析

Diagnostic value of peripheral blood EOS combined with NLR for chronic rhinosinusitis

目的探讨外周血嗜酸性粒细胞(EOS)、中性粒细胞与淋巴细胞计数比值(NLR)联合检测诊断慢性鼻-鼻窦炎(CRS)价值。方法选取2017年6月-2020年6月成都医学院第三附属医院80例CRS患者纳入CRS组,按照患者手术以后病理检测组织内EOS的计数水平来分型分为嗜酸粒细胞性慢性鼻-鼻窦炎组(ECRS组,n=59)与非嗜酸粒细胞性慢性鼻-鼻窦炎组(NECRS组,n=21)两个亚组,同时筛选同期健康体检者40例纳入对照组,所有纳入对象均接受EOS、NLR检测,比较不同组别EOS、NLR水平差异,采用ROC曲线分析EOS、NLR及其两者联合对ECRS的诊断价值。结果CRS组外周血EOS、NLR水平高于对照组(P<0.05);外周血EOS、NLR水平联合检测在CRS疾病诊断中ROC曲线下面积为0.929高于单独EOS、NLR水平诊断曲线下面积0.834、0.810(P<0.05);ECRS组外周血EOS水平高于NECRS组(P<0.05);ECRS组与NECRS组NLR水平比较(P>0.05);以外周血EOS水平为0.27×10^(9)/L作为截点值,其对于ECRS与NECRS两种病理类型CRS鉴别ROC曲线下面积为0.762。结论CRS患者外周血EOS、NLR水平升高,二者联合检测可提高CRS疾病诊断价值,ECRS患者外周血EOS水平高于NECRS患者,但两种不同病理分型患者外周血NLR水平无明显差异,临床CRS分型的区分可依据外周血EOS水平来初步判断。

Objective To explore the value of peripheral blood eosinophils(EOS)combined with neutrophil to lymphocyte ratio(NLR)in the diagnosis of chronic rhinosinusitis(CRS).Methods A total of 80patients with chronic rhinosinusitis(CRS)in the The Third Affiliated Hospital of Chengdu Medical College from June 2017to June 2020were enrolled as CRS group.According to postoperative EOS count in pathological examination,they were divided into eosinophilic CRS group(ECRS group,n=59)and non-ECRS group(NECRS group,n=21).Another 40healthy controls during the same period were enrolled as control group.All were tested for EOS and NLR.The differences in levels of EOS and NLR among different groups were compared.The diagnostic value of EOS,NLR and their combination for ECRS was analyzed by ROC curves.Results The levels of peripheral blood EOS and NLR in CRS group were higher than those in control group(P<0.05).The area under the ROC curve(AUC)of EOS combined with NLR for the diagnosis of CRS was 0.935,higher than that of EOS and NLR alone(0.832,0.815)(P<0.05).The level of peripheral blood EOS in ECRS group was higher than that in NECRS group(P<0.05),while there was no significant difference in NLR level between the two groups(P>0.05).AUC of EOS(cut-off value=0.27×10^(9)/L)for the differentiation of ECRS and NECRS was 0.762.Conclusion The levels of peripheral blood EOS and NLR increase in CRS patients.The combined detection of the two can improve the diagnostic value for CRS.The level of peripheral blood EOS in ECRS patients is higher than that in NECRS patients.However,there is no significant difference in level of peripheral blood NLR between the two kinds of patients.Clinically,classifications of CRS can be preliminarily determined based on the level of peripheral blood EOS.