腺样体肥大伴变应性鼻炎患儿致敏原谱及腺样体组织中IL-25 IL-32 EOS表达分析及诊断价值

An Analysis of Allergen Spectrum and Expression of IL-25 IL-32 EOS in Adenoid Tissue in Children with Adenoid Hypertrophy and Allergic Rhinitis and the Diagnostic Value

目的:分析腺样体肥大伴变应性鼻炎患儿致敏原谱及腺样体组织中IL-25、IL-32、EOS表达及诊断价值。方法:选取96例变应性鼻炎患儿作为研究的临床资料进行回顾性分析,研究时间2017年5月至2020年5月,按照1∶1个体匹配原则选择腺样体肥大伴变应性鼻炎患者48例为A组与单纯变应性鼻炎患者48例为B组。另选取48例健康体检者设立为对照组,且观察变应性鼻炎患儿的致敏原谱,评估三组受检人员的IL-25、IL-32、EOS,分析腺样体肥大伴变应性鼻炎患者的独立影响因素,IL25、IL32与EOS相关性,以及评估IL25、IL32、EOS及三项联合的AUC值。结果:96例变应性鼻炎患儿经血清变应原总IgE检测,其阳性为94例(97.92%);其中仅对一种变应原过敏共42例(44.68%),对2种以上变应原过敏共52例(55.32%)。吸入性变应原中以户尘螨阳性率最高,以狗毛皮屑阳性率最低;食入性变应原中以鸡蛋白阳性率最高,以鱼蟹虾阳性率最低。A组与B组的IL-25、IL-32、EOS均高于对照组(P均<0.05);A组的IL-25、IL-32、EOS高于B组(P均<0.05)。经二元Logistic回归分析显示,IL-25、IL-32、EOS均是腺样体肥大伴变应性鼻炎患者的独立影响因素(P<0.05)。Pearson相关性分析显示,IL25、IL32与EOS呈正相关(r=0.742/0.871,P<0.05)。ROC曲线分析显示,IL-25、IL-32、EOS、三项联合预测腺样体肥大伴变应性鼻炎的AUC值分别为(0.855、0.977、0.996、0.994,P<0.05);敏感度分别为(72.90%、95.80%、93.80%、100.00%)、特异度分别为(91.70%、93.70%、100.00%、91.70%)。结论:IL-25、IL-32、EOS在腺样体肥大伴变应性鼻炎患儿中呈异常表达,对临床诊断具有一定指导作用。

Objective:To analyze the allergen spectrum of children with adenoid hypertrophy and allergic rhinitis and the expression of IL-25,IL-3 and EOS in adenoid tissues and their diagnostic value.Methods:96 children with allergic rhinitis were selected as the clinical data of the study for retrospective analysis.The study period was from May 2017 to May 2020.Patients with adenoid hypertrophy and allergic rhinitis were selected according to the 1:1 individual matching principle.48 Cases make up group A and 48 cases of patients with simple allergic rhinitis make up group B.In addition,48 healthy subjects were selected as the control group,and the allergen spectrum of children with allergic rhinitis was observed,the IL-25,IL-32,and EOS of the three groups of subjects were evaluated,and the adenoid hypertrophy and degeneration were analyzed.The independent influencing factors of patients with atopic rhinitis,the correlation between IL25,IL32 and EOS,and the AUC value of IL25,IL32,EOS and the combination of the three.Results:96 children with allergic rhinitis were tested for serum allergen total IgE,94 cases(97.92%)were positive;42 cases(44.68%)were allergic to only one allergen,and were allergic to more than two kinds of allergens.There were 52 cases(55.32%)of primary allergies.Among the inhaled allergens,the positive rate of house dust mites was the highest,and the positive rate of dog dander was the lowest;among the inhaled allergens,the positive rate of chicken protein was the highest,and the positive rate of fish,crabs and shrimps was the lowest.The levels of IL-25,IL-32 and EOS in group A and B were higher than those in the control group(all P<0.05);the levels of IL-25,IL-32 and EOS in group A were higher than those in group B(all P<0.05).The binary logistic regression analysis showed that IL-25,IL-32 and EOS were all independent influencing factors in patients with adenoid hypertrophy and allergic rhinitis(P<0.05).Pearson correlation analysis showed that IL25,IL32 and EOS were positively correlated(r=0.742/0.871,P<0.05).ROC curve analysis showed that the AUC values of IL-25,IL-32,EOS,and the three items combined to predict adenoid hypertrophy with allergic rhinitis were(0.855,0.977,0.996,0.994,P<0.05);the sensitivity was respectively Are(72.90%,95.80%,93.80%,100.00%),specificity is(91.70%,93.70%,100.00%,91.70%).Conclusion:IL-25,IL-32 and EOS are abnormally expressed in children with adenoid hypertrophy and allergic rhinitis,and they have a certain guiding role in clinical diagnosis.