新型鼻分泌物嗜酸粒细胞阳离子蛋白-髓过氧化物酶试纸在变应性鼻炎中的应用价值

doi:10.6040/j.issn.1673-3770.0.2023.449

摘要/Abstract

摘要： 目的探讨新型鼻分泌物嗜酸粒细胞阳离子蛋白-髓过氧化物酶(eosinophil cationic protein-myeloperoxidase, ECP-MPO)试纸在变应性鼻炎(allergic rhinitis, AR)中的应用价值。方法收集2022年1月至2022年12月于武汉市中心医院耳鼻喉科门诊就诊的123例AR患者为AR组,36例健康人群为对照组。AR组患者使用布地奈德鼻喷雾剂治疗14 d。使用鼻分泌物ECP-MPO试纸测定AR组治疗前后和对照组的ECP显色程度,同时检测鼻分泌物中ECP浓度。制作鼻分泌物涂片统计嗜酸性粒细胞百分比(percentage of eosinophils, EOS%),并收集主观症状评分。分析各指标间的差异性及相关性,采用受试者工作曲线(receiver operating characteristic curve, ROC)分析ECP试纸评分在AR辅助诊断中的工作效能。结果治疗前AR组鼻分泌物ECP试纸评分高于治疗后以及对照组,ECP试纸评分与鼻分泌物ECP浓度、鼻分泌物EOS%、鼻结膜炎鼻部症状总评分(rhinoconjunctivitis total nasal symptom score, TNSS)、视觉模拟评分(visual analogue scale, VAS)呈正相关。ROC曲线分析结果显示鼻分泌物ECP试纸评分诊断AR患者的ROC曲线下面积为0.935,且诊断的最佳cut-off值为1级,诊断的敏感度为89.4%,特异度为91.7%。结论 ECP-MPO试纸可有效检测鼻分泌物中的ECP,其显色级别可反映AR患者的症状严重程度,对于AR具有较好的辅助诊断价值。

关键词: 变应性鼻炎, 嗜酸粒细胞阳离子蛋白, 鼻分泌物, 鼻结膜炎鼻部症状总评分, 视觉模拟评分

Abstract: Objective To investigate the value of a novel nasal secretion eosinophil cationic protein-myeloperoxidase(ECP-MPO)test paper in allergic rhinitis(AR). Methods We included 123 patients with AR admitted to the department of otolaryngology head and neck surgery, the central hospital of Wuhan from January 2022 to December 2022 as the AR group and 36 healthy patients as the control group. AR patients were treated with budesonide nasal spray for 14 days. The degree of ECP coloration in the AR group before and after treatment and in the control group was determined using nasal secretion ECP-MPO test paper, and the concentration of ECP in nasal secretion was also detected. Nasal secretion smears were made to count the percentage of eosinophils(EOS%), and subjective symptom scores were collected. The differences and correlations between the indexes were analyzed, and the working efficacy of ECP test paper scores in the auxiliary diagnosis of AR was analyzed by using the receiver operating characteristic curve(ROC). Results The pre-treatment ECP test strip scoring was higher in AR group than the post-treatment and the control group. The chromogenic grade correlated positively with ECP concentration of nasal secretion, EOS% of nasal secretion, rhinoconjunctivitis total nasal symptom score(TNSS)and visual analogue scale(VAS). ROC curve analysis showed that the area under ROC curve was 0.935, the sensitivity was 89.4% and specificity was 91.7% for the detection of AR with 1 as cut-off value. Conclusion The ECP-MPO test paper can effectively detect ECP concentration in nasal secretions, and its chromogenic grade can reflect the severity of symptoms in AR patients, which has a good auxiliary diagnostic value for AR.

Key words: Allergic rhinitis, Eosinophil cationic protein, Nasal secretion, Rhinoconjunctivitis total nasal symptom score, Visual analogue scale

中图分类号:

R765.21

张竹萍,彭孜灿,肖振龙,李程,喻迪,王兴龙,陈伟,郭蓓. 新型鼻分泌物嗜酸粒细胞阳离子蛋白-髓过氧化物酶试纸在变应性鼻炎中的应用价值[J]. 山东大学耳鼻喉眼学报, 2025, 39(3): 129-134.

ZHANG Zhuping, PENG Zican, XIAO Zhenlong, LI Cheng, YU Di, WANG Xinglong, CHEN Wei, Guo Bei. The value of a novel nasal secretion eosinophil cationic protein-myeloperoxidase test paper assay in allergic rhinitis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(3): 129-134.

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