外周血嗜酸性粒细胞相关复合指标对嗜酸性粒细胞型慢性鼻窦炎伴鼻息肉的预测价值

The predictive value of peripheral blood eosinophil related composite index for eosinophilic chronic rhinosinusitis with nasal polyps

目的探究外周血嗜酸性粒细胞(peripheral blood eosinophil,bEOS)相关复合指标对嗜酸性粒细胞型慢性鼻窦炎伴鼻息肉(eosinophilic chronic rhinosinusitis with nasal polyps,ECRSwNP)的预测价值。方法回顾性分析2003~2005年和2014~2016年就诊于北京协和医院初诊为慢性鼻窦炎伴鼻息肉并行鼻内镜手术的115例和114例患者的临床资料,寻找bEOS相关复合指标与组织中嗜酸性粒细胞百分比(tissue eosinophil percent,tEOS%)的相关性,评估bEOS%、bEOS绝对值、嗜酸性粒细胞/中性粒细胞比值(bENR)、嗜酸性粒细胞/淋巴细胞比值(bELR)的预测价值,以及该预测价值的稳定性。结果bEOS%、bEOS绝对值、bENR、bELR与tEOS%具有相关性(P<0.001),且对ECRSwNP有预测价值(P<0.001)。其中,bENR的预测价值最大(AUC=0.817),bEOS%次之(AUC=0.815)。比较不同年代bEOS相关复合指标对ECRSwNP的预测价值无统计学差异(|U|<1.96,P>0.05)。结论bEOS相关复合指标对ECRSwNP有中度预测价值,bENR的预测价值最高,且随炎症浸润程度无改变。

OBJECTIVE To explore the predictive value of peripheral blood eosinophil(bEOS)related composite index for eosinophilic chronic rhinosinusitis with nasal polyps(ECRSwNP).METHODS 115 and 114 patients with chronic rhinosinusitis with nasal polyps who underwent endoscopic sinus surgery in Peking Union Medical College Hospital from 2003 to 2005 and 2014 to 2016 were retrospectively analyzed,to explore the correlation between tissue EOS percentage(tEOS%)and bEOS related composite index.The predictive value of bEOS%,bEOS absolute value,blood EOS to neutrophil ratio(bENR)and blood EOS to lymphocyte ratio(bELR),and the stability of the predictive value were evaluated.RESULTS There was correlation between bEOS%,bEOS absolute value,bENR,bELR and tEOS%(P<0.001),and it had predictive value for ECRSwNP(P<0.001).The prediction value of bENR was the highest(AUC=0.817),followed by bEOS%(AUC=0.815).There was no significant difference in the predictive value of bEOS related composite index for ECRSwNP(|U|<1.96,P>0.05)between the two stages.CONCLUSION bEOS composite index has moderate predictive value for ECRSwNP,and the predictive value of bENR is the highest,and there is no change with the degree of inflammatory infiltration.