摘要
Abstract
Objective To investigate the changes and clinical significance of serum leukotriene B4(LTB4)and Nod-like receptor C4(NLRC4)levels in children with chronic rhinosinusitis(CRS).Methods A total of 184 children with CRS(CRS group)who received endoscopic sinus therapy in hospital from January 2020 to October 2021 were gathered and grouped into recurrence group and non-recurrence group according to 3-month postoperative prognosis.Another 100 healthy children with physical examination were selected as normal control(NC)group.The serum levels of LTB4 and NLRC4 were detected by enzyme-linked immunosorbent assay,and the serum levels of LTB4 and NLRC4 were compared among groups.The visual analogue scale(VAS)scores,Lund-Kennedy scores and the changes of serum levels of LTB4 and NLRC4 before operation and at 1 week,4 weeks and 8 weeks after operation in the CRS group were analyzed.Pearson method was used to analyze correlation between serum LTB4 and NLRC4 levels.Multivariate logistic regression analysis was carried out on possi-ble influencing factors for postoperative recurrence in children with CRS.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of preoperative serum LTB4 and NLRC4 for postoperative recurrence.Results The ser-um LTB4 and NLRC4 levels in the CRS group were(62.85±13.17)pg/mL and(759.82±108.46)pg/mL,respectively,and those in the NC group were(17.43±4.08)pg/mL and(203.75±36.93)pg/mL,respectively,so difference between the two groups was statistically significant(P＜0.001).Correlation analysis showed that serum LTB4 levels were positively correla-ted with NLRC4 levels in the CRS group(r=0.638,P＜0.001).Serum LTB4 levels and NLRC4 levels were not associated with age,gender,and nasal polyps in children with CRS(P＞0.05).The VAS score,Lund-Kennedy score,and serum LTB4 and NLRC4 levels sequentially decreased before surgery,at 1 week after surgery,4 weeks after surgery,and 8 weeks after sur-gery(P＜0.05).The preoperative serum LTB4 and NLRC4 levels in the recurrence group were(77.62±15.85)pg/mL and(860.39±126.92)pg/mL,respectively,significantly higher than those in the non-recurrence group([57.78±12.25]pg/mL and[725.32±102.13]pg/mL),and difference between the two groups was statistically significant(P＜0.001).Multivariate lo-gistic regression analysis showed that preoperative serum LTB4 and NLRC4 levels were risk factors for recurrence in children with CRS(OR=2.114,95%CI=1.129-3.958;OR=1.883,95%CI=1.190-2.979)(P＜0.05 or 0.01).The area un-der the curve(AUC)of NLRC4,LTB4 and their combination for predicting postoperative recurrence was 0.839,0.824,and 0.913,respectively.Conclusion The expression levels of serum LTB4 and NLRC4 are increased in children with chronic rhinosinusitis,which are closely related to the prognosis.The combination of them is expected to be an early predictor of postoperative recurrence of chronic rhinosinusitis.关键词
慢性鼻窦炎/鼻窦内窥镜/白三烯B4/Nod样受体家族蛋白4/预后Key words
chronic rhinosinusitis(CRS)/sinus endoscopy/leukotriene B4(LTB4)/Nod-like receptor C4(NLRC4)/prognosis分类
临床医学
