NLR、LMR、PLR预测慢性鼻窦炎鼻内镜术后复发价值

doi:10.6040/j.issn.1673-3770.0.2019.478

摘要/Abstract

摘要： 目的探讨中性粒细胞与淋巴细胞比值(NLR)、淋巴细胞与单核细胞比值(LMR)、血小板与淋巴细胞比值(PLR)预测慢性鼻窦炎鼻内镜术后复发价值。方法选取2016年3月至2018年3月收治的慢性鼻窦炎鼻内镜治疗患者60例。所有患者均术后随访6个月,并根据鼻窦炎是否复发分为术后复发组(n=21)和术后未复发组(n=39)。同期选取87例健康体检者作为对照组(n=87)。收集并分析所有患者NLR、LMR、PLR数值,并绘制上述指标受试者工作特征曲线(ROC)。结果 CRS组NLR、PLR水平高于对照组,差异具有统计学意义(P<0.05);CRS组LMR水平低于对照组,差异具有统计学意义(P<0.01);术后未复发组NLR、LMR、PLR水平与对照组差异无统计学意义(P>0.05);术后复发组NLR、PLR水平高于术后未复发组,差异具有统计学意义(P<0.05);术后复发组LMR水平低于术后未复发组,差异具有统计学意义(P<0.01);NLR的敏感度、特异度分别为63.33%(19/30)、93.33%(28/30);LMR的敏感度、特异度分别为72.00%(18/25)、91.43%(32/35);PLR的敏感度、特异度分别为67.86%(19/28)、93.75%(30/32);ROC曲线显示:NLR、LMR、PLR曲线下面积分别为0.719(0.587~0.851)、0.922(0.853~0.991)、0.830(0.587~0.851)。结论 NLR、LMR、PLR能较好地预测慢性鼻窦炎鼻内镜术后复发情况。

关键词: 慢性鼻窦炎, 鼻内镜, 复发, 中性粒细胞, 淋巴细胞, 血小板

Abstract: Objective To explore the value of the neutrophil to lymphocyte ratio(NLR), lymphocyte to monocyte ratio(LMR), and platelet to lymphocyte ratio(PLR)in predicting the recurrence of chronic sinusitis after endoscopic sinus surgery. Methods Sixty patients with chronic sinusitis treated by endoscopy from March 2016 to March 2018 were selected. All patients were followed up for 6 months and were divided into the postoperative recurrence group(n=21)and non-postoperative recurrence group(n=39)according to whether sinusitis recurred or not. In the same period, 87 people who underwent a health examination at our hospital were selected as the control group(n=87). The NLR, LMR and PLR of all patients were collected and analyzed. The receiver operating characteristic curve(ROC)of the above indicators was drawn. Results The NLR and PLR levels in the chronic rhinosinusitis(CRS)group were higher than those in the control group(p<0.05). The level of LMR in the CRS group was lower than that in the control group (p<0.01). There was no significant difference in NLR, LMR and PLR between the non-postoperative recurrence group and the control group (p>0.05). The levels of NLR and PLR in the postoperative recurrence group were higher than those in the non-postoperative recurrence group (p<0.05). The level of LMR in the postoperative recurrence group was lower than that in the non-postoperative recurrence group (p<0.01). The sensitivity and specificity of NLR were 63.33%(19/30)and 93.33%(28/30), respectively. The sensitivity and specificity of LMR were 72.00%(18/25)and 91.43%(32/35), respectively. The sensitivity and specificity of PLR were 67.86%(19/28)and 93.75%(30/32), respectively. The ROC curves showed that the areas under NLR, LMR and PLR curves were 0.719(0.587-0.851), 0.922(0.853-0.991), and 0.830(0.587-0.851), respectively. Conclusion NLR, LMR and PLR can help to predict chronic sinusitis recurrence after endoscopic sinus surgery.

Key words: Chronic sinusitis, Nasal endoscopy, Recurrence, Neutrophil, Lymphocyte, Platelet

中图分类号:

R765

谢书华, 杨竹梅, 刘慧茹, 董晶. NLR、LMR、PLR预测慢性鼻窦炎鼻内镜术后复发价值[J]. 山东大学耳鼻喉眼学报, 2020, 34(1): 54-57.

XIE Shuhua, YANG Zhumei, LIU Huiru, DONG Jing. Value of NLR, LMR, and PLR in predicting chronic sinusitis recurrence after endoscopic sinus surgery[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(1): 54-57.

参考文献

[1] Velasquez N, Thamboo A, Abuzeid WM, et al. Safe treatment of ethmoid sinusitis utilizing minimally invasive ethmoid punch sinusotomy in chronic rhinosinusitis without polyposis patients[J]. Laryngoscope, 2017, 127(6): 1268-1275. doi:10.1002/lary. 26493.
[2] 陈宗燕, 黄礼辉, 胡韬. 鼻内窥镜下手术治疗慢性鼻窦炎鼻息肉的疗效观察[J]. 贵州医药, 2017, 41(10): 1066-1067. doi: 10.3969/j.issn.1000-744X. 2017.10.023.
[3] 郑富春, 侯勇. 加强药物疗法联合鼻内镜手术治疗慢性鼻-鼻窦炎疗效观察[J]. 海南医学, 2017, 28(12): 1941-1943. doi:10.3969/j.issn.1003-6350. 2017.12.016. ZHENG Fuchun, HOU Yong. Clinical observation of strengthening drug therapy combined with nasal endoscopic surgery for chronic nasal sinusitis[J]. Hainan Med J, 2017, 28(12): 1941-1943. doi:10.3969/j.issn.1003-6350. 2017.12.016.
[4] Kuruvilla ME, Levy J. Efficacy of reslizumab in eosinophilic chronic sinusitis with nasal polyposis[J]. J Allergy Clin Immunol, 2018, 141(2): AB270. doi:10.1016/j.jaci. 2017.12.860.
[5] 于锋, 焦粤农, 钟胜长. 慢性鼻-鼻窦炎术后复发相关因素的多元回归分析[J]. 临床耳鼻咽喉头颈外科杂志, 2016, 30(9): 737-741. doi:10.13201/j.issn.1001-1781. 2016.09.017 YU Feng, JIAO Yuenong, ZHONG Shengchang. The multiple regression analysis of related factors in chronic rhinosinusitis postoperative recurrence[J]. J Clin Otorhinolaryngol Head Neck Surg, 2016, 30(9): 737-741. doi:10.13201/j.issn.1001-1781. 2016.09.017.
[6] 中华耳鼻咽喉头颈外科杂志编委会. 慢性鼻-鼻窦炎诊断和治疗指南[J]. 中国临床医生, 2010, 38(4): 73-74.
[7] Rai G, Das S, Ansari MA, et al. Phenotypic and functional profile of Th17 and Treg cells in allergic fungal sinusitis[J]. Int Immunopharmacol, 2018, 57: 55-61. doi:10.1016/j.intimp. 2018.02.009.
[8] Wright ED, Christodoulopoulos P, Frenkiel S, et al. Expression of interleukin(IL)-12(p40)and IL-12(beta 2)receptors in allergic rhinitis and chronic sinusitis[J]. Clin Exp Allergy, 1999, 29(10): 1320-1325. doi:10.1046/j.1365-2222.1999. 00637.x.
[9] Jenks M, Willits I, Turner EE, et al. The XprESS multi-sinus dilation system for the treatment of chronic sinusitis: A NICE medical technology guidance[J]. Appl Health Econ Health Policy, 2017, 15(5): 567-582. doi:10.1007/s40258-017-0337-7.
[10] 肖四方, 潘建华, 向延根. NLR、PLR和LMR在急诊甲、乙型流感病毒感染者中的临床意义[J]. 热带医学杂志, 2018, 18(11): 1478-1481. doi: CNKI:SUN:RDYZ.0. 2018-11-019. XIAO Sifang, PAN Jianhua, XIANG Yangen. Clinical value of NLR, PLR and LMR in emergency patients with influenza A or B[J]. J Trop Med, 2018, 18(11): 1478-1481. doi: CNKI:SUN:RDYZ.0. 2018-11-019.
[11] Ying HQ, Deng QW, He BS, et al. The prognostic value of preoperative NLR, d-NLR, PLR and LMR for predicting clinical outcome in surgical colorectal cancer patients[J]. Med Oncol, 2014, 31(12): 305. doi:10.1007/s12032-014-0305-0.
[12] Meng XC, Chang Q, Liu YY, et al. Determinant roles of gender and age on SII, PLR, NLR, LMR and MLR and their reference intervals defining in Henan, China: A posteriori and big-data-based[J]. J Clin Lab Anal, 2018, 32(2): e22228. doi:10.1002/jcla. 22228.
[13] Rajwa P,(·overZ)yczkowski M, Paradysz A, et al. Evaluation of the prognostic value of LMR, PLR, NLR, and dNLR in urothelial bladder cancer patients treated with radical cystectomy[J]. Eur Rev Med Pharmacol Sci, 2018, 22(10): 3027-3037. doi:10.26355/eurrev_201805_15060.
[14] 张劼, 龚齐. 不同分型慢性鼻-鼻窦炎患者外周血嗜酸性粒细胞与中性粒细胞百分比及变态反应临床差异性分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 54-57. doi: 10.6040/j.issn.1673-3770.0.2017.422. ZHANG Jie, GONG Qi. Clinical significance of eosinophils and neutrophils in blood and allergic reaction in patients with chronic rhinosinusitis[J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32(3): 54-57. doi: 10.6040/j.issn.1673-3770.0.2017.422.
[15] Dine G, Ali-Ammar N, Brahimi S, et al. Chronic sinusitis in a patient with selective IgG4 subclass deficiency controlled with enriched immunoglobulins[J]. Clin Case Rep, 2017, 5(6): 792-794. doi:10.1002/ccr3.936.
[16] 徐文中, 刘春艳. 过敏性鼻炎患儿淋巴细胞亚群、血清IgE水平的变化及其相关性[J]. 中国免疫学杂志, 2016, 32(4): 550-552. doi: 10.3969/j.issn.1000-484X. 2016.04.022. XU Wenzhong, LIU Chunyan. Changes and correlation of lymphocyte subsets and serum levels of IgE in children with allergic rhinitis[J]. Chin J Immunol, 2016, 32(4): 550-552. doi: 10.3969/j.issn.1000-484X. 2016.04.022.
[17] Lennard CM, Mann EA, Sun LL, et al. Interleukin-1 beta, interleukin-5, interleukin-6, interleukin-8, and tumor necrosis factor-alpha in chronic sinusitis: response to systemic corticosteroids[J]. Am J Rhinol, 2000, 14(6): 367-373. doi:10.2500/105065800779954329.
[18] Kim YH, Kim J, Kang MG, et al. Optic nerve changes in chronic sinusitis patients: Correlation with disease severity and relevant sinus location[J]. PLoS One, 2018, 13(7): e0199875. doi:10.1371/journal.pone. 0199875.

相关文章 15

[1]	陈雪松,付伟伟,刘江涛. 中性粒细胞淋巴细胞比值和血小板淋巴细胞比值对调强放疗鼻咽癌患者的预后价值[J]. 山东大学耳鼻喉眼学报, 2020, 34(1): 50-53.
[2]	刘佳, 付勇. 儿童慢性鼻窦炎的外科治疗研究进展[J]. 山东大学耳鼻喉眼学报, 2019, 33(6): 29-33.
[3]	许庚. 儿童慢性鼻窦炎的常规诊断不宜使用CT扫描[J]. 山东大学耳鼻喉眼学报, 2019, 33(6): 8-9.
[4]	杨一帆, 程雷. 儿童鼻窦炎与哮喘:统一气道疾病[J]. 山东大学耳鼻喉眼学报, 2019, 33(6): 10-15.
[5]	李强,刘志元,周涵. 鼻内镜下蝶腭动脉阻断术治疗老年难治性鼻出血[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 92-95.
[6]	王海英. 鼻内镜下二线减张鼻中隔矫正术43例临床分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 166-168.
[7]	陈国辉,和守睆,孙青,高天乐,白广平. 鼻内镜术中不同中鼻甲处理方式治疗慢性鼻-鼻窦炎伴鼻息肉效果比较[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 82-86.
[8]	潘晓菲,王军,肖洋,马丽晶. LncRNA CTB-147C22.8对复发性呼吸道乳头状瘤细胞侵袭的影响[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 66-70.
[9]	李华斌,赖玉婷,姜文秀. 慢性鼻窦炎的内表型研究进展及精准治疗[J]. 山东大学耳鼻喉眼学报, 2019, 33(3): 9-13.
[10]	陈慧君,宋圣花,周涵,董伟达,乔明哲,陈曦,徐进,林子萍,邢光前. 血小板与淋巴细胞比值对喉癌复发的预测价值[J]. 山东大学耳鼻喉眼学报, 2019, 33(3): 106-110.
[11]	鞠丽娴,李井成,夏克玉,董伟达. 鼻内镜下联合自制角度喉钳切除声门暴露困难声带息肉23例[J]. 山东大学耳鼻喉眼学报, 2019, 33(3): 116-118.
[12]	陈冬平,杨致欢,张炎,方楠,齐斌. 复发鼻咽癌手术治疗地位的思考[J]. 山东大学耳鼻喉眼学报, 2019, 33(2): 12-16.
[13]	姜彦. 鼻咽癌复发及鼻内镜外科手术的应用[J]. 山东大学耳鼻喉眼学报, 2019, 33(2): 1-11.
[14]	刘全,孙希才,于华鹏,赵可庆,张焕康,赵卫东,顾瑜蓉,李厚勇,王德辉,余洪猛. 鼻内镜下鼻咽癌切除术的手术分型[J]. 山东大学耳鼻喉眼学报, 2019, 33(2): 39-45.
[15]	邱前辉,陈卓. 鼻内镜手术治疗首诊局部晚期鼻咽癌及放疗后严重并发症的作用[J]. 山东大学耳鼻喉眼学报, 2019, 33(2): 17-20.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed