Zagólski O, Stręk P, Jurczak W, Gorzedowski P
Abteilung für Hals‑, Nasen- und Ohrenheilkunde, St.-John-Grande-Krankenhaus, Krakau, Polen.
Abteilung für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinik der Jagiellonen-Universität, Krakau, Polen.
HNO. 2018 Aug;66(8):605-612. doi: 10.1007/s00106-018-0527-0.
The aim of this study was to verify whether the following peripheral blood cell count and inflammation-based markers differ between various types of chronic rhinosinusitis (CRS): neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR) and platelet-to-lymphocyte ratio (PLR), as well as erythrocyte sedimentation rate (ESR) and C‑reactive protein (CRP) levels.
In all, 386 patients had complete peripheral blood count, ESR, CRP and nasal cytology. The severity of CRS symptoms was assessed using three-stage Lund-Mackay computed tomography (CT) scores. The participants were stratified based on the results of nasal cytology and by the presence of nasal polyps (NP). The inflammation-based markers were calculated by dividing the cell numbers of the different cell types by numbers of the other cell types.
Blood leukocyte and neutrophil counts were higher in neutrophilic CRS. Differences between patients with CRS with nasal polyps (NP) and CRS without NP were significant for blood leukocytes, neutrophils, monocytes, eosinophils, CRP, NLR and MLR values. In CRS with NP, peripheral blood leukocyte, neutrophil, monocyte and eosinophil counts, as well as CRP, NLR and MLR values were higher than in CRS without NP. Our results show that all individuals with CRS could benefit from the analysis of blood counts and inflammation-based markers at the beginning of their evaluation. High levels of inflammation-based markers might guide the clinician towards planning more radical CRS therapy and use of systemic anti-inflammatory medication.
本研究旨在验证以下外周血细胞计数和基于炎症的标志物在不同类型的慢性鼻-鼻窦炎（CRS）之间是否存在差异：中性粒细胞与淋巴细胞比值（NLR）、单核细胞与淋巴细胞比值（MLR）和血小板与淋巴细胞比值（PLR），以及红细胞沉降率（ESR）和C反应蛋白（CRP）水平。
共有386例患者进行了完整的外周血细胞计数、ESR、CRP和鼻细胞学检查。使用三阶段Lund-Mackay计算机断层扫描（CT）评分评估CRS症状的严重程度。根据鼻细胞学检查结果和鼻息肉（NP）的存在情况对参与者进行分层。基于炎症的标志物通过将不同细胞类型的细胞数除以其他细胞类型的细胞数来计算。
嗜中性粒细胞性CRS患者的血液白细胞和中性粒细胞计数较高。伴有鼻息肉（NP）的CRS患者与不伴有NP的CRS患者在血液白细胞、中性粒细胞、单核细胞、嗜酸性粒细胞、CRP、NLR和MLR值方面存在显著差异。在伴有NP的CRS中，外周血白细胞、中性粒细胞、单核细胞和嗜酸性粒细胞计数以及CRP、NLR和MLR值均高于不伴有NP的CRS。我们的结果表明，所有CRS患者在评估开始时都可以从血细胞计数和基于炎症的标志物分析中获益。高水平的基于炎症的标志物可能会指导临床医生规划更激进的CRS治疗方案并使用全身性抗炎药物。
