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[儿童和青少年鼻炎患者的鼻细胞学分析]

[Analysis of nasal cytology in children and adolescents with rhinitis].

作者信息

Lozano Natalia A, Saranz Ricardo J, Lozano Alejandro, Bovina Martijena María Del Pilar, Ramirez Maximiliano, Ponzio Marina F, Berardi Yanina V, Sosa Ana G, Cóncari Eugenia

机构信息

Universidad Católica de Córdoba. Clínica Universitaria Reina Fabiola, Servicio de Alergia e Inmunología. Facultad de Medicina, Cátedra de Inmunología.

Universidad Católica de Córdoba. Facultad de Medicina. Cátedra de Histología II y Anatomía Patológica y Fisiopatología.

出版信息

Rev Fac Cien Med Univ Nac Cordoba. 2017;74(2):126-133.

Abstract

BACKGROUND

Nasal cytology in a easy-to apply method to differentiate rhinitis phenotypes from a physiopathogenic and diagnostic perspective. There are controversies about the relationship between clinical severity of rhinitis and inflammatory patterns expressed in the nasal cytology.

OBJECTIVES

To study the characteristic of the eosinophil and neutrophil patterns in the nasal scraping for Allergic Rhinitis (AR) and Non Allergic Rhinitis (NAR) and its relationship with the clinical grades of rhinitis established by the Allergic Rhinitis and its Impact on Asthama Guideline (ARIA) Methods: In a observational, cross-sectional study we included patients aged 5 to 18 years presenting symptoms of either allergic (AR) or non- allergic rinitis (NAR) without asthma. Cytology was performed by analyzing nasal scraping obtained from the mucosal surface of the inferior turbinate and samples were stained using thr hematoxylin and eosin stain procedure. Inflammatory patterns between AR and NAR and between clinical grades of rhinitis classified by ARIA guide were compared.

RESULTS

A total of 231 patients were included. Patients with AR exhibited higher percentage of eosinophils in nasal cytology than those with NAR (p = 0.0012) but no differences were observed in neutrophil count (p = 0.4011). No differences in the percentage of eosinophils and neutrophils between different grades of AR (p = 0.7342 and p = 0.0797 respectively) and NAR (p = 0.1010 and p = 0.1422 respectively) were observed.

CONCLUSION

Eosinophil count in the nasal cytology was useful to differentiate rhinitis with a positive allergen skin test from rhinitis with negative skin test, but as neutrophils count, does not help to distinguish clinical grades of AR and NAR as classified by ARIA.

摘要

背景

鼻细胞学检查是一种从生理病理和诊断角度区分鼻炎表型的简便方法。关于鼻炎临床严重程度与鼻细胞学检查中所表达的炎症模式之间的关系存在争议。

目的

研究变应性鼻炎(AR)和非变应性鼻炎(NAR)鼻刮片中嗜酸性粒细胞和中性粒细胞模式的特征及其与变应性鼻炎及其对哮喘的影响指南(ARIA)所确立的鼻炎临床分级的关系。方法:在一项观察性横断面研究中,我们纳入了5至18岁出现变应性(AR)或非变应性鼻炎(NAR)症状且无哮喘的患者。通过分析从下鼻甲黏膜表面获取的鼻刮片进行细胞学检查,并使用苏木精和伊红染色程序对样本进行染色。比较AR和NAR之间以及ARIA指南分类的鼻炎临床分级之间的炎症模式。

结果

共纳入231例患者。AR患者鼻细胞学检查中嗜酸性粒细胞百分比高于NAR患者(p = 0.0012),但中性粒细胞计数无差异(p = 0.4011)。不同AR分级(分别为p = 0.7342和p = 0.0797)和NAR分级(分别为p = 0.1010和p = 0.1422)之间嗜酸性粒细胞和中性粒细胞百分比无差异。

结论

鼻细胞学检查中的嗜酸性粒细胞计数有助于将变应原皮肤试验阳性的鼻炎与皮肤试验阴性的鼻炎区分开来,但与中性粒细胞计数一样,无助于区分ARIA分类的AR和NAR的临床分级。

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