无明显致病因素的真菌性食管炎患者炎症及免疫学指标水平及内镜下表现

Levels of Inflammatory and Immunological Indexes and Endoscopic Manifestations of Fungal Esophagitis Patients Without Obvious Pathogenic Factors

目的分析无明显致病因素的真菌性食管炎患者炎症及免疫学指标水平及内镜下表现。方法选取93例无明显致病因素的真菌性食管炎患者纳入病例组,依据成组病例对照研究方法随机选取同时期108例健康体检者为对照组,回顾性分析病例组内镜下表现并比较两组炎症及免疫功能相关指标间的差异,筛选表达差异的指标,通过受试者工作特征(ROC)曲线评估其对无明显致病因素真菌性食管炎的诊断价值。结果无明显致病因素的真菌性食管炎患者内镜下表现以KodsiⅠ、Ⅱ级为主,其中食管全段、食管上段为其好发部位。两组白细胞计数(WBC)、血小板与淋巴细胞比值(PLR)、CD4^(+)/CD8^(+)比较,差异有统计学意义(P<0.05);通过ROC曲线分析WBC、PLR、CD4^(+)/CD8^(+)的诊断效能,结果显示单项指标均具有一定的诊断预测效能,当3项指标联合时诊断效能最高。结论无明显致病因素的真菌性食管炎内镜下表现以轻症为主,WBC、PLR、CD4^(+)/CD8^(+)联合使用时具有良好的诊断价值,在临床工作中加强对此类指标的动态监测有利于临床医生早发现、早诊断及合理治疗该类疾病。

Objective To analyze the levels of inflammatory and immunological indexes and endoscopic manifestations in patients with fungal esophagitis without obvious pathogenic factors.Methods A total of 93 patients with fungal esophagitis without obvious pathogenic factors were included in the case group,according to the method of group case-control study,108 healthy people during the same period were randomly selected as the control group.The endoscopic manifestations of the case group were retrospectively analyzed and the differences between the two groups in inflammatory and immune function related indicators were compared and to screen the indicators with statistical different expression.The diagnostic value of related indexes for fungal esophagitis without obvious pathogenic factors was evaluated by receiver operating characteristic(ROC)curve.Results The endoscopic manifestations of fungal esophagitis without obvious pathogenic factors were mainly KodsiⅠandⅡ,and the whole esophagus and upper esophagus were the most common sites.White blood count(WBC),platelet-to-lymphocyte ratio(PLR)and CD4^(+)/CD8^(+) between the two groups were compared,and the differences were statistically significant(P<0.05).The diagnostic efficacy of WBC,PLR and CD4^(+)/CD8^(+) were analyzed by ROC curve,and the result showed that each index had certain diagnostic predictive efficacy,and the diagnosis efficiency was highest when the three indexes were combined.Conclusion Endoscopic manifestations of fungal esophagitis without obvious pathogenic factors are mainly mild.The combination of WBC,PLR and CD4^(+)/CD8^(+) has good diagnostic value for fungal esophagitis.Strengthening the dynamic monitoring of these indicators in clinical work is conducive to early detection,early diagnosis and reasonable treatment of these diseases.