Department of Otorhinolaryngology and Head and Neck Surgery, Oulu University Hospital, P.O. Box 21, FI-90029, OYS, Oulu, Finland.
PEDEGO Research Unit, University of Oulu, Oulu, Finland.
Curr Allergy Asthma Rep. 2018 Feb 21;18(2):13. doi: 10.1007/s11882-018-0761-2.
Diagnosis of bacterial acute rhinosinusitis is difficult. Several attempts have been made to clarify the diagnostic criteria. Inflammatory biomarkers are easily obtainable variables that could shed light on both the pathophysiology and diagnosis of bacterial acute rhinosinusitis. The purpose of this review article is to assess literature concerning the course of inflammatory biomarkers during acute rhinosinusitis and the use of inflammatory biomarkers in diagnosing bacterial acute rhinosinusitis.
We included C-reactive protein, erythrocyte sedimentation rate, white blood cell counts, procalcitonin, and nasal nitric oxide in this review and found that especially elevated C-reactive protein and erythrocyte sedimentation rate are related to a higher probability of a bacterial cause of acute rhinosinusitis. Still, normal levels of these two biomarkers are quite common as well, or the levels can be heightened even during viral respiratory infection without suspicion of bacterial involvement. Elevated levels of C-reactive protein or erythrocyte sedimentation rate support diagnosis of bacterial acute rhinosinusitis, but due to a lack of sensitivity, they should not be used to screen patients for bacterial acute rhinosinusitis.
细菌性急性鼻-鼻窦炎的诊断较为困难。目前已提出多种尝试来明确诊断标准。炎症生物标志物是一种易于获得的变量,可阐明细菌性急性鼻-鼻窦炎的病理生理学和诊断。本文旨在评估有关急性鼻-鼻窦炎期间炎症生物标志物变化过程以及炎症生物标志物在诊断细菌性急性鼻-鼻窦炎中的应用的文献。
我们在综述中纳入了 C 反应蛋白、红细胞沉降率、白细胞计数、降钙素原和鼻一氧化氮,发现 C 反应蛋白和红细胞沉降率升高尤其与细菌性急性鼻-鼻窦炎的可能性增加相关。然而,这两种生物标志物的正常水平也很常见,或者即使在病毒性呼吸道感染期间升高,也不能怀疑存在细菌感染。C 反应蛋白或红细胞沉降率升高支持细菌性急性鼻-鼻窦炎的诊断,但由于缺乏敏感性,不应将其用于筛查细菌性急性鼻-鼻窦炎患者。