Luo Hong, Zhang Jianbin, Yu Ye, Liu Jun, Jiang Yan, Yan Nengbing, Wang Pengju, Kong Weijia
Department of Otorhinolaryngology, Affiliated Hospital of Hubei arts and science, Xiangyang Central Hospital, Xiangyang, 441021, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2012 Jun;26(11):494-8.
To evaluate the treatment responses of persistent allergic rhinitis with and without eosinophils (EOS) in nasal discharge to inhaled glucocorticosteroid (CS), and therefore to verify whether low eosinophil level in nasal discharge can predict poor response to treatment with CS.
Forty-two symptomatic allergic rhinitis patients, who had not received CS therapy in three months preceding the study, were examined before and 2 month, 4 months and 6 months after treatment with CS. At each visit, all patients underwent symptom scoring and physical sign scoring. The level of eosinophil cationic protein (ECP) in the nasal discharge supernatants was measured by radioimmunoassay. The patients were divided into 2 groups according to nasal discharge EOS percentages, an EOS group (EOS > or = 3%) and a non-EOS group (EOS < 3%). The response to CS therapy (as measured by symptom and physical sign scores) and the changes of nasal discharge measurements were compared between the 2 groups.
In the EOS group, the baseline EOS [0.086 (0.065; 0.176)] and ECP level [(326 +/- 145) microg/L] were significantly higher than EOS [0.016 (0.005; 0.022)] and ECP level [(154 +/- 58) microg/L] of the non-EOS group, t = 4.40, 3.32, respectively, all P < 0.01. After 2 months and 6 months of CS therapy, the nasal discharge EOS, ECP level were 0.038 (0.006; 0.070), 0.019 (0.010; 0.060), (175 +/- 122) microg/L, (175 +/- 153) microg/L, respectively in the EOS group,which were significantly different as compared to baseline values (F = 6.73, 7.38, respectively all P < 0.05). But in the non-EOS group, the nasal discharge EOS and ECP level were 0.014 (0.004; 0.032), 0.015 (0.010; 0.026), (118 +/- 60) microg/L, (112 +/- 60) microg/L, respectively at 2 and 6 months, which showed that the nasal discharge EOS level and the symptom and physical sign scores did not improve significantly (F = 0.82, P > 0.05), but the ECP level did improve (F = 3.78, P < 0.05). The average daily dose of CS was not different between the two groups at any visits.
In persistent allergic rhinitis with low EOS in nasal discharge, CS therapy for 6 months failed to improve symptoms and physical signs.
评估鼻分泌物中伴有和不伴有嗜酸性粒细胞（EOS）的持续性变应性鼻炎患者对吸入糖皮质激素（CS）的治疗反应，从而验证鼻分泌物中低水平嗜酸性粒细胞是否可预测对CS治疗反应不佳。
42例有症状的变应性鼻炎患者，在研究前3个月未接受CS治疗，在CS治疗前、治疗后2个月、4个月和6个月进行检查。每次就诊时，所有患者均进行症状评分和体征评分。通过放射免疫测定法测量鼻分泌物上清液中嗜酸性粒细胞阳离子蛋白（ECP）水平。根据鼻分泌物EOS百分比将患者分为2组，EOS组（EOS≥3%）和非EOS组（EOS<3%）。比较两组对CS治疗的反应（通过症状和体征评分衡量）以及鼻分泌物测量值的变化。
EOS组的基线EOS[0.086（0.065；0.176）]和ECP水平[（326±145）μg/L]显著高于非EOS组的EOS[0.016（0.005；0.022）]和ECP水平[（154±58）μg/L]，t分别为4.40、3.32，均P<0.01。CS治疗2个月和6个月后，EOS组鼻分泌物EOS、ECP水平分别为0.038（0.006；0.070）、0.019（0.010；0.060）、（175±122）μg/L、（175±153）μg/L，与基线值相比有显著差异（F分别为6.73、7.38，均P<0.05）。但在非EOS组，2个月和6个月时鼻分泌物EOS和ECP水平分别为0.014（0.004；0.032）、0.015（0.010；0.026）、（118±60）μg/L、（112±60）μg/L，表明鼻分泌物EOS水平以及症状和体征评分未显著改善（F=0.82，P>0.05），但ECP水平有所改善（F=3.78，P<0.05）。两组在任何就诊时CS的平均日剂量均无差异。
在鼻分泌物中EOS水平较低的持续性变应性鼻炎患者中，CS治疗6个月未能改善症状和体征。
