成人慢性鼻窦炎患者血清维生素C表达水平及与免疫功能相关性分析

Analysis of serum Vitamin C expression level and its correlation with immune function in adult patients with chronic sinusitis

目的:探讨维生素C在成人慢性鼻窦炎(CRS)患者中的表达以及与免疫功能的相关性。方法:收集2018年5月—2020年6月在武汉大学人民医院耳鼻咽喉头颈外科行鼻内镜手术的患者315例,其中CRS患者207例,分为CRS不伴鼻息肉(CRSsNP)组110例与CRS伴鼻息肉(CRSwNP)组97例;单纯行鼻中隔矫正患者108例作为对照组。所有患者行血清维生素A、C、D、E含量测定,其中107例(对照组39例,CRSsNP组35例,CRSwNP组33例)患者进行血清IL-2、TNF-α、IFN-γ、IL-4、IL-5、IL-6、IL-10等细胞因子和IgA、IgM、IgG、C3、C4等免疫蛋白水平的检测。结果:CRSwNP组患者血清维生素C和IL-10水平明显低于对照组(P<0.05),血清C4水平明显高于对照组(P<0.05);血清维生素C水平下降与IL-10水平下降呈正相关,与C4水平呈负相关;同时CRSsNP患者的维生素C水平也较低,C3和C4水平升高。结论:成人CRS患者的维生素C水平较正常人群低,C4水平较高;CRSwNP患者的IL-10水平较低;维生素C影响患者的免疫平衡和抗氧化水平,在CRS及鼻息肉的发病中起到一定的作用。

Objective:To investigate the expression of Vitamin C in adult patients with chronic rhinosinusitis(CRS)and its correlation with immune function.Methods:A total of 315 patients who underwent nasal endoscopic surgery at the Department of Otolaryngology Head and Neck Surgery and undergoing nasal endoscopic surgery were collected from Renmin Hospital of Wuhan University from May 2018 to June 2020,including 207 CRS patients,who were divided into CRS without nasal polyps(CRSsNP)group(110 cases)and CRS with nasal polyps(CRSwNP)group(97 cases);108 patients with nasal septum correction were selected as the control group.All patients underwent serum Vitamin A,C,D,and E tests.Among them,107 patients(39 in the control group,35 in the CRSsNP group,and 33 in the CRSwNP group)were treated with serum IL-2,TNF-α,IFN-γ,IL-4,IL-5,IL-6,IL-10,etc.Detection of cytokines and immune protein levels such as IgA,IgM,IgG,C3,and C4.Results:The serum levels of Vitamin C and IL-10 in the CRSwNP group were significantly lower than those in the control group(P<0.05),and the serum C4 level was significantly higher(P<0.05);the serum Vitamin C level decreased with the level of IL-10,the decline is positively correlated,while negatively correlated with C4 levels;CRSsNP patients also had lower Vitamin C levels and higher C3 and C4 levels.Conclusion:The Vitamin C level in adult patients with CRS is lower than that in the normal population,and the level of C4 is higher;the level of IL-10 in patients with CRSwNP is lower;Vitamin C affects the immune balance and antioxidant level of patients,and in the pathogenesis of CRS and nasal polyps play a certain role.