Diagnostic value of a novel test paper detection of ECP in nasal secretion for allergic rhinitis
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摘要: 目的 探究鼻分泌物嗜酸粒细胞阳离子蛋白(ECP)的试纸检测法在变应性鼻炎(AR)中的诊断价值。方法 选取107例AR患者(AR组)与40例健康志愿者(对照组)的鼻分泌物及血清样本，对AR组进行鼻炎主观症状学评估。采用鼻分泌物ECP-MPO试纸评估鼻分泌物中ECP显色程度，同时检测鼻分泌物中ECP浓度和血清中各细胞因子浓度。分析各指标之间的差异性和相关性，并采用受试者工作特征曲线(ROC)计算鼻分泌物ECP显色分级和浓度的最佳界值与检验效能。结果 AR患者的鼻分泌物ECP浓度较对照组显著升高(P < 0.05)。鼻分泌物ECP试纸检测法的显色分级和鼻分泌物中ECP浓度呈明显正相关(P < 0.05)，不同显色等级之间差异显著(P < 0.05)。鼻分泌物ECP显色分级和血清特异性IgE分级结果有很好的对称性(P < 0.05)，同时二者具有很高的诊断一致性(P < 0.05)。鼻分泌物中ECP浓度ROC的曲线下面积为0.807 2，当截断值为0.980 5时，对应64%的敏感性和85%的特异性；鼻分泌物ECP显色分级的ROC的曲线下面积为0.941 9，当截断值为1级时，对应92%的敏感性和94%的特异性。鼻分泌物中ECP浓度和血清各细胞因子无明显相关性(P>0.05)。结论 鼻分泌物ECP的试纸检测法和血清学变应原检测结果具有很好的一致性，并且能初步判断患者的过敏严重程度，敏感性和特异性较好，尤其适合在过敏原检测设备缺乏的基层医院推广应用。
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关键词:
- 鼻炎，变应性 /
- 嗜酸粒细胞阳离子蛋白 /
- 免疫球蛋白E /
- 细胞因子
Abstract: Objective To explore the diagnostic value of a novel test paper, which detect eosinophil cationic protein(ECP) of nasal secretion in allergic rhinitis(AR).Methods Nasal secretion and serum samples from 107 patients with allergic rhinitis(AR group) and 40 healthy volunteers(control group) were selected. The nasal symptoms were also evaluated in AR group. The degree of ECP coloration was evaluated by nasal secretion eosinophil cationic protein-myeloperoxid(ECP-MPO) test paper, and the concentration of ECP in nasal secretion and the concentration of cytokines in serum were detected at the same time. The difference and correlation among these indexes were analyzed. The best cutoff value and test efficiency of ECP chromogenic grade and concentration of nasal secretion were calculated by receiver operating characteristic curve(ROC).Results The concentration of ECP in nasal secretion of AR patients was significantly higher than that of healthy controls(P < 0.05). The color grade of nasal secretion detected by the test paper was positively correlated with the concentration of ECP in nasal secretion(P < 0.05), and there was significant difference among different grades(P < 0.05). There was a satisfying symmetry between the ECP color grade of nasal secretion and the serum specific IgE(sIgE) level as well as a high diagnostic consistency between them(P < 0.05). The area under the curve(AUC) of ECP concentration ROC in nasal secretion was 0.807 2, corresponding to 64% sensitivity and 85% specificity when the cutoff value was set at 0.980 5; when the cutoff value was set at 1, the AUC of nasal secretion ECP color grading was 0.941 9, corresponding to 92% sensitivity and 94% specificity. No clear correlation between the concentration of ECP in nasal secretion and serum cytokines was found(P>0.05).Conclusion The results of this novel test paper is in good agreement with those of serological allergens. It could serve as a preliminary test to evaluate the severity of allergy with satisfactory sensitivity and specificity, and is especially suitable in clinical practice for primary hospital.-
Key words:
- rhinitis, allergic /
- eosinophil cationic protein /
- Immunoglobulin E /
- cytokine
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表 1 鼻分泌物ECP显色分级与血清sIgE等级情况
例 鼻分泌物ECP分级 血清sIgE等级 合计 0级 1级 2级 3级 4级 5级 6级 0级 37 0 0 2 2 2 0 43 1级 2 2 5 15 9 1 2 36 2级 0 0 0 6 12 13 5 36 3级 1 0 1 1 4 11 14 32 合计 40 2 6 24 27 27 21 147 
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表 2 鼻分泌物ECP显色分级结果敏感度与特异度分析
ECP分级 敏感性 特异性 0级 1.000 0 0 1级 0.943 9 0.925 0 2级 0.626 2 0.975 0 3级 0.298 1 0.975 0
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