The auxiliary diagnostic value of ECP and MPO expression in nasal secretions in different types of rhinitis
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摘要: 目的 通过评估鼻腔分泌物中嗜酸粒细胞阳离子蛋白(eosinophil cationic protein，ECP)与髓过氧化物酶(myeloperoxidase，MPO)在不同类型鼻炎的表达情况，探讨其在不同类型的鼻炎鉴别诊断中的价值。方法 临床选取684例受试者，其中急性鼻炎组62例，变应性鼻炎(AR组)378例，血管运动性鼻炎组94例，嗜酸粒细胞增多性非变应性鼻炎(AR with eosinophilia syndrome，NARES组)70例以及80例健康对照者(对照组)。收集5组受试者的鼻分泌物样本，利用瑞氏染色计数炎性细胞百分比，胶体金法检测ECP/MPO的表达，并分析临床诊断、鼻分泌物中的炎性细胞与ECP/MPO表达之间的关联性。结果 鼻细胞学涂片结果显示，与对照组比较，AR组和NARES组嗜酸粒细胞百分比均显著升高(P＜0.05)，而中性粒细胞百分比差异无统计学意义(P>0.05)；急性鼻炎组中性粒细胞百分比较对照组显著升高(P＜0.05)，而嗜酸粒细胞百分比差异无统计学意义(P>0.05)；血管运动性鼻炎组嗜酸粒细胞和中性粒细胞均较对照组差异无统计学意义(P>0.05)。胶体金结果显示不同类型鼻炎ECP/MPO表达存在差异，其中急性鼻炎组49例(79.0%)表达为ECP+/MPO+；AR组267例(70.6%)和NARES组56例(75.7%)表达为ECP+/MPO-；血管运动性鼻炎组80例(85.1%)和对照组69例(86.3%)表达为ECP-/MPO-。结论 不同类型的鼻炎ECP和MPO表达存在差异，对各类型鼻炎的鉴别诊断和治疗方案的选择具有一定的参考价值。
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关键词:
- 鼻炎 /
- 鼻细胞学 /
- 嗜酸粒细胞阳离子蛋白 /
- 髓过氧化物酶
Abstract: Objective To evaluate the expression of eosinophil cationic protein and myeloperoxidase in nasal secretions in different types of rhinitis, and to explore their values in the differential diagnosis of different types of rhinitis.Methods Six hundred and eighty-four subjects were selected, including 62 subjects in the acute rhinitis group, 378 subjects in the allergic rhinitis group, 94 subjects in the vasomotor rhinitis group, 70 subjects in the eosinophilic non-allergic rhinitis group, and 80 subjects in the control group. Nasal secretion samples were collected from the five groups, and the percentages of inflammatory cells were counted by Rachel's staining, and the expression of ECP/MPO was detected by colloidal gold assay. The correlation between the clinical diagnosis, the inflammatory cells in the nasal secretions and the expression of ECP/MPO was analyzed.Results Nasal cytological smears showed that compared with the control group, the percentage of eosinophils in the AR and NARES groups were significantly higher (P < 0.05), while the percentage of neutrophils was not different (P>0.05); the percentage of neutrophils was significantly higher in the acute rhinitis group compared with the control group (P < 0.05), while the percentage of eosinophils was not statistically different (P>0.05); in vasomotor rhinitis group, the eosinophils and neutrophils were not statistically different compared with the control group(P> 0.05). The colloidal gold results showed that there were differences in the expression of ECP/MPO in different types of rhinitis, among which 49 cases (79.0%) in the acute rhinitis group expressed ECP+/MPO+; 267 cases (70.6%) in the AR group and 56 cases (75.7%) in the NARES group expressed ECP+/MPO-; 80 cases (85.1%) in the vasomotor rhinitis group and 69 cases (86.3%) in the control group expressed ECP-/MPO-.Conclusion The differences in ECP and MPO expression between different types of rhinitis have certain reference value for the differential diagnosis of different types of rhinitis and the selection of treatment programs.-
Key words:
- rhinitis /
- nasal cytology /
- eosinophil cationic protein /
- myeloperoxidase
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表 1 各组基本临床资料和鼻细胞学结果
项目 急性鼻炎组 AR组 血管运动性鼻炎组 NARES组 对照组 例数 62 378 94 70 80 年龄/岁 4.6±3.5 22.5±14.7 26.3±17.2 34.19±13.69 31.88±7.96 性别(男∶女)/例 40∶22 200∶178 41∶53 40∶30 41∶39 鼻细胞学分级 3.41±0.951) 2.30±1.201) 0.41±0.85 2.37±1.101) 0.32±0.62 嗜酸粒细胞/% 2.92±7.11 69.40±38.601) 0.24±1.56 85.80±24.811) 0.00±0.00 中性粒细胞/% 92.22±20.571) 21.74±33.23 24.72±42.13 13.91±24.86 27.50±44.93 与对照组比较，1)P＜0.01。 
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表 2 各型鼻炎ECP/MPO表达情况
例(%) 组别 ECP/MPO 合计 -/- -/+ +/- +/+ 急性鼻炎组 7(11.3) 6(9.7) 0(0) 49(79.0)1) 62(100.0) AR组 51(13.5) 6(1.6) 267(70.6)1) 54(14.3) 378(100.0) 血管运动性鼻炎组 80(85.1) 2(2.1) 5(5.3) 7(7.4) 94(100.0) NARES组 11(15.7) 0(0) 56(80.0)1) 3(4.3) 70(100.0) 对照组 69(86.3) 4(5.0) 2(2.5) 5(6.3) 80(100.0) 与对照组比较，1)P＜0.05。
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表 3 鼻炎不同细胞学分型的ECP/MPO表达情况
例(%) 细胞学分型 ECP/MPO 合计 -/- +/- +(-)/+ 分级≤1级 169(62.8) 81(30.1) 19(7.1) 269(100.0) 嗜酸粒细胞≥10% 29(9.3) 235(75.3) 48(15.4) 312(100.0) 中性粒细胞>90% 20(19.4) 14(13.6) 69(67.0) 103(100.0)
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表 4 各型鼻炎鼻细胞学与ECP/MPO表达情况
例 组别 鼻细胞学与ECP/MPO 合计 分级≤1级ECP-/MPO- 嗜酸粒细胞≥10%ECP+/MPO- 中性粒细胞>90%ECP+(-)/MPO+ 急性鼻炎 2/2 0/6 50/54 62 AR组 28/94 195/256 11/28 378 血管运动性鼻炎组 73/82 0 5/12 94 NARES组 3/19 40/50 1/1 70 对照组 63/72 0 2/8 80
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