血清嗜酸粒细胞阳离子蛋白水平与变应性鼻炎及慢性鼻-鼻窦炎关系的探讨

目的 探讨变应性鼻炎(allergic rhinitis,AR)和慢性鼻-鼻窦炎伴鼻息肉(chronic rhinosinusitis with polyps,CRSWP)患者血清中嗜酸粒细胞阳离子蛋白(eosinophil cationic protein,ECP)的水平及其与患者鼻部过敏症状的关系.方法 用UniCAP100系统进行吸入物变应原过筛试验Phadiatop和检测血清ECP水平.取87例吸人性AR患者、49例CRSWP患者和20例健康人静脉血,采用荧光酶免疫分析法,检测血清ECP水平.对87例吸入性AR患者进行症状评分.结果 ①吸入性AR组和CRSWP过筛阳性组Phadiatop中位数(M)和四分位间距25%,75%]表示,以下同]分别为5185.0983.0,14469.0]Fu和317.5125.0,526.8]Fu,健康对照组和CRSWP过筛阴性组分别为43.529.0,105.0]Fu和30.028.0,43.0]Fu;②吸入性AR组血清ECP为24.814.6,49.1]μg/L,CRSWP过筛阳性组和阴性组分别为7.73.3,25.6]μg/L和12.56.7,16.7]μg/L,健康对照组为8.85.4,20.2]μg/L.吸入性AR组ECP明显高于CRSWP过筛阳性组、阴性组和健康对照组,行秩和检验示(z值分别为-2.821,-4.449和-4.028,P值均＜0.05),差异有统计学意义.CRSWP过筛阳性组和阴性组血清ECP较正常对照组无明显升高;③吸入性AR组患者鼻部症状评分(x-±s)为(9.139±1.892),与Phadiatop值呈明显正相关(r=0.854,P＜0.05);与血清ECP水平有一定相关性(r=0.434,P＜0.05).血清ECP和Phadiatop值有一定相关性(r=0.392,P＜0.05).结论 吸入性AR患者症状发作期血清ECP明显升高,且和疾病严重程度有相关性.血清ECP是一种较好且方便的吸入性AR辅助筛查工具,同时还可作为判断患者病情严重程度和预后的客观指标之一.而CRSWP患者血清ECP无明显升高.

Serum ECP levels in patients with allergic rhinitis and chronic rhinosinusitis

Objective To investigate the serum eosinophil cationic protein(ECP)levels in patients with allergic rhinitis(AR)or chronic rhinosinusitis with polyps(CRSWP),and its relations with allergic symptoms in patients with AR.Methods The ECP in serum and Phadiatop tests were detected by UniCAP100 system.Blood sample was taken from 87 patients with inhaled AR,49 patients with CRSWP and 20 healthy individuals.The serum ECP levels were detected by enzyme-linked immunosorbent assay.The allergic symptoms in patients with inhaled AR were graded.Results Phadiatop level was 5185.0983.0,14469.0]Fu in inhaled AR,317.5125.0,526.8]Fu in CRSWP with Phadiatop positive,30.028.0,43.0]Fu in CRSWP with Phadiatop negative and 43.529.0,105.0]Fu in healthy individuals.The level of ECP in patients with inhaled AR was 24.814.6,49.1]μg/L,higher than that in CRSWP with Phadiatop positive 7.73.3,25.6]μg/L,CRSWP with Phadiatop negative 12.56.7,16.7]μg/L and control 8.85.4,20.2]μg/L.The difference was significant There were correlations among the allergic symptoms,serum ECP and Phadiatop levels.Conclusions Among patients with inhaled AR,there was an up-regulated concentration of serum ECP,which had relations to allergic symptoms.The detection of serum ECP could be used as a convenient screening test for inhaled AR Its concentration had correlation with the severity and prognosis of the disease.To the contrary,the serum ECP did not significantly increased in patients with CRSWP.