血清ACE2表达与慢性鼻-鼻窦炎伴鼻息肉患者鼻内镜术后复发的关系

The Relationship Between Serum ACE2 Expression and Postoperative Recurrence in Patients with Chronic Sinusitis and Nasal Polyps Undergoing Endoscopic Sinus Surgery

目的 探究血清血管紧张素转换酶2(ACE2)表达与慢性鼻-鼻窦炎伴鼻息肉(CRSwNP)患者鼻内镜术后复发的关系。方法 收集2021年3月至2022年3月在本院进行鼻内镜手术的CRSwNP患者128例,另选取健康体检者100例作为对照。根据CRSwNP患者鼻内镜术后是否复发分为复发组40例和未复发组88例,酶联免疫法检测CRSwNP患者血清ACE2的表达水平。Spearman和Pearson法分析ACE2与病变程度、术后感染、Lund-Mackay评分、Davos评分、嗜酸性粒细胞计数、IL-5、IFN-γ的相关性;Logistic回归分析CRSwNP患者鼻内镜术后复发的影响因素,ROC曲线分析血清ACE2对CRSwNP患者鼻内镜术后是否复发的预测价值。结果 CRSwNP患者血清ACE2表达水平显著低于健康体检者(P<0.05),鼻内镜术后复发组CRSwNP患者血清ACE2表达水平显著低于未复发组(P<0.05)。鼻内镜术后复发组和未复发组患者病变程度、术后感染、Lund-Mackay评分、Davos评分、嗜酸性粒细胞计数、IL-5、IFN-γ比较,差异具有统计学意义(P<0.05);Spearman分析结果表明,ACE2表达与病变程度、术后感染、Lund-Mackay评分和Davos评分呈负相关(P<0.05),Pearson分析结果表明,ACE2表达与IL-5、嗜酸性粒细胞计数呈负相关,与IFN-γ呈正相关(P<0.05);Logistic回归分析结果表明,ACE2、术后感染、IL-5、IFN-γ是CRSwNP患者鼻内镜术后复发的影响因素(P<0.05);ROC曲线分析结果表明,ACE2评估CRSwNP患者鼻内镜术后复发的AUC为0.897。结论 血清ACE2表达与CRSwNP患者鼻内镜术后复发具有密切关系,是患者鼻内镜术后复发的影响因素,对评估CRSwNP患者鼻内镜术后复发具有较好预测价值。

Objective To investigate the relationship between the expression of serum angiotensin converting enzyme 2(ACE2)and postoperative recurrence in patients with chronic sinusitis and nasal polyps(CRSwNP)undergoing endoscopic sinus surgery.Methods A total of 128 CRSwNP patients who underwent nasal endoscopic surgery in our hospital from March,2021 to March,2022 were collected for the study,while another 100 healthy individuals were collected as controls.According to whether CRSwNP patients experienced recurrence after endoscopic sinus surgery,these patients were divided into a recurrence group of 40 cases and a non-recurrence group of 88 cases.Enzyme linked immunosorbent assay(ELISA)was applied to detect the expression level of serum ACE2 in patients with CRSwNP.Spearman and Pearson methods were applied to analyze the correlation between ACE2 and lesion severity,postoperative infection,Lund-Mackay score,Davos score,eosinophil count,IL-5,and IFN-γ;Logistic regression was applied to identify influencing factors of postoperative recurrence in CRSwNP patients undergoing endoscopic sinus surgery,ROC curve was drawn to evaluate the predictive value of serum ACE2 levels for the recurrence of CRSwNP patients after endoscopic sinus surgery.Results The serum ACE2 expression level in CRSwNP patients was significantly lower than that in healthy individuals(P<0.05),while the serum ACE2 expression level in the recurrence group was significantly lower than that in the non-recurrence group(P<0.05).There were statistically significant differences in lesion severity,postoperative infection,Lund-Mackay score,Davos score,eosinophil count,IL-5,and IFN-γbetween the recurrence group and non-recurrence group(P<0.05);Spearman analysis showed that the expression of ACE2 was negatively correlated with the severity of the lesion,postoperative infection,Lund-Mackay score,and Davos score(P<0.05),while Pearson analysis showed that the expression of ACE2 was negatively correlated with IL-5 and eosinophil count,and positively correlated with IFN-γ(P<0.05);Logistic regression analysis showed that ACE2,postoperative infection,IL-5,and IFN-γwere the influencing factors for postoperative recurrence in CRSwNP patients undergoing endoscopic sinus surgery(P<0.05);AUC of postoperative recurrence in CRSwNP patients evaluated by ACE2 was 0.897.Conclusion The expression of serum ACE2 is closely related to the recurrence of CRSwNP patients after endoscopic sinus surgery,and is an influencing factor for the recurrence of patients after endoscopic sinus surgery.It has a good predictive value for evaluating the recurrence of CRSwNP patients after endoscopic sinus surgery.