外周血嗜酸粒细胞分界值在诊断嗜酸粒细胞鼻息肉中的价值

发布时间：2018-05-17 00:37

本文选题：嗜酸粒细胞鼻息肉 + logistic回归分析　；参考：《华中科技大学》2011年硕士论文

【摘要】：目的:为寻找诊断嗜酸粒细胞鼻息肉的简便方法,对外周血嗜酸粒细胞值并结合其他临床指标的诊断价值进行分析,试图确定一个最佳的临界值来对国人伴鼻息肉的慢性鼻-鼻窦炎进行嗜酸粒细胞和非嗜酸粒细胞的分类。方法:收集2004年-2010年双侧伴鼻息肉的慢性鼻-鼻窦炎患者共133例,其中通过HE染色将组织区分为嗜酸粒细胞鼻息肉(Eos CRSwNP)52例和非嗜酸粒细胞鼻息肉(non-Eos CRSwNP)81例。然后通过对嗜酸粒细胞鼻息肉和非嗜酸粒细胞鼻息肉两组患者的性别、年龄、有无哮喘病史、变应性鼻炎病史、病程、症状VAS评分、息肉评分、Lund-Macky CT评分、IgE、变应性体质检测等多种因素分别进行单因素的logistic回归分析,通过p值,优势比(OR),筛选出一个和(或)两个对区分Eos CRSwNP和non-Eos CRSwNP有预测意义的指标,衡量其预测能力的大小。接着选取有预测意义的指标进行受试者工作特征曲线(ROC)曲线分析,通过曲线下面积直观的判断分界值与灵敏度和特异度的关系,并找到合适的切入点即分界值,进一步区分Eos CRSwNP和non-Eos CRSwNP。最后用所选的分界值对另一组独立样本的数据进行预测,并进一步分析其阳性预测值和阴性预测值,从而判断分界值的预测效果。结果:性别,外周血嗜酸粒细胞绝对值,外周血嗜酸粒细胞百分比,外周血IgE评分在Eos CRSwNP和non-Eos CRSwNP中比较有差异,外周血嗜酸粒细胞绝对值和百分比p0.001,且OR值较大,当外周血嗜酸粒细胞绝对值在0.215×109/L,灵敏度和特异度分别为69.2%和76.5%。外周血嗜酸粒细胞百分比为2.65%时,灵敏度和特异度分别为76.9%和64.2%。当嗜酸粒细胞绝对值0.145×109/L且IgE为12.1ku/l时,诊断的灵敏度和特异度为80%和85.2%,当嗜酸粒细胞百分比为2.65%且IgE12.1ku/l时,诊断的灵敏度和特异度为80%和81.5%。结论:通过对性别,外周血嗜酸粒细胞绝对值,外周血嗜酸粒细胞百分比及外周血IgE的综合分析,可以对嗜酸粒细胞性鼻息肉进行初步的筛选。
[Abstract]:Objective: to find a simple method for the diagnosis of eosinophil nasal polyps and to analyze the diagnostic value of eosinophils in peripheral blood combined with other clinical indexes. An attempt was made to determine an optimal threshold for the classification of eosinophil and non-eosinophil in Chinese chronic rhinosinusitis with nasal polyps. Methods: a total of 133 cases of chronic rhinosinusitis with nasal polyps were collected from 2004 to 2010. The tissues were divided into eosinophil nasal polyps (Eos CRSwNP)52) and non-eosinophil nasal polyps (non-Eos CRSwNP)81) by HE staining. Then, the sex, age, history of asthma, history of allergic rhinitis, course of disease, symptom VAS score of patients with eosinophil nasal polyps and non-eosinophil nasal polyps were evaluated. Polyp score Lund-Macky CT score IgE, allergic constitution test and other factors were analyzed by single factor logistic regression analysis. One and / or two predictors of Eos CRSwNP and non-Eos CRSwNP were screened by p and odds ratio. Measure its predictive power. Then the predictive indexes are selected to analyze the ROCcurve of the subjects, and the relationship between the boundary value and sensitivity and specificity is judged directly by the area under the curve, and the appropriate cut-in point is found, that is, the threshold value. Further distinguish Eos CRSwNP from non-Eos CRSwNP. Finally, the selected boundary value is used to predict the data of another group of independent samples, and the positive predictive value and the negative predictive value are further analyzed to judge the prediction effect of the boundary value. Results: sex, absolute value of peripheral blood eosinophil, percentage of peripheral blood eosinophil, IgE score of peripheral blood were different between Eos CRSwNP and non-Eos CRSwNP. The absolute value and percentage of eosinophil in peripheral blood were p0.001, and OR value was higher. When the absolute value of eosinophils in peripheral blood was 0.215 脳 109 / L, the sensitivity and specificity were 69.2% and 76.5%, respectively. When the percentage of eosinophils in peripheral blood was 2.65, the sensitivity and specificity were 76.9% and 64.2%, respectively. When the absolute value of eosinophil was 0.145 脳 109 / L and IgE was 12.1ku/l, the sensitivity and specificity of diagnosis were 80% and 85.2%, and when the percentage of eosinophil was 2.65% and IgE12.1ku/l, the sensitivity and specificity of diagnosis were 80% and 81.5%. Conclusion: sex, absolute value of eosinophil in peripheral blood, percentage of eosinophil in peripheral blood and IgE in peripheral blood can be used to screen eosinophil nasal polyps.
【学位授予单位】：华中科技大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R765.25

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