慢性鼻窦炎患者血清IL-6、CCL-4、ECP水平变化及对术后复发的预测价值

Changes of serum IL-6, CCL-4, and ECP levels in patients with chronic sinusitis and their predictive value for postoperative recurrence

摘要:

目的 探讨慢性鼻窦炎患者血清白细胞介素-6（IL-6）、趋化因子4（CCL-4）、嗜酸性细胞阳离子蛋白（ECP）水平变化及对术后复发的预测价值。方法 回顾性2021年12月—2023年12月盐城市第三人民医院收治的154例慢性鼻窦炎患者的临床资料，将其归为研究组，并以同期入院体检的60例健康人群为对照组。根据患者术后复发情况将研究组分为复发组63例和未复发组91例。比较研究组与对照组、复发组与未复发组血清IL-6、CCL-4、ECP水平。采用受试者工作特征（ROC）曲线分析血清IL-6、CCL-4、ECP水平对慢性鼻窦炎患者术后复发的预测效能。结果 研究组血清IL-6、CCL-4、ECP水平均高于对照组（P <0.05）。复发组血清IL-6、CCL-4、ECP水平均高于未复发组（P <0.05）。ROC曲线分析结果显示，血清IL-6、CCL-4、ECP预测慢性鼻窦炎患者术后复发的曲线下面积分别为0.768（95% CI：0.705，0.822）、0.791（95% CI：0.731，0.844）、0.815（95% CI：0.755，0.863）；敏感性分别为62.50%（95% CI：0.538，0.706）、77.94%（95% CI：0.700，0.846）、67.65%（95% CI：0.591，0.754）；特异性分别为83.12%（95% CI：0.729，0.907）、74.03%（95% CI：0.628，0.834）、80.52%（95% CI：0.699，0.887）。结论 慢性鼻窦炎患者血清IL-6、CCL-4、ECP水平较健康人群有明显升高趋势，其水平与术后复发有关，水平越高术后复发概率越大，临床早期检测患者血清IL-6、CCL-4、ECP水平，可有效预测患者术后复发，为临床早期预防性治疗提供参考。

Abstract:

Objective To explore the changes in serum interleukin-6 (IL-6), chemokine ligand 4 (CCL-4), and eosinophil cationic protein (ECP) levels in patients with chronic sinusitis and their predictive value for postoperative recurrence.Methods The clinical data of 154 patients with chronic sinusitis were retrospectively analyzed from December 2021 to December 2023, classified as the study group; 60 healthy subjects admitted for physical examination during the same period were included as the control group. Serum levels of IL-6, CCL-4, and ECP were compared between the two groups. Based on postoperative recurrence, patients in the study group were divided into recurrence group (n = 63) and non-recurrence group (n = 91), and serum IL-6, CCL-4, and ECP levels were compared between these subgroups. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive efficiency of serum IL-6, CCL-4, and ECP levels for postoperative recurrence in patients with chronic sinusitis.Results Serum levels of IL-6, CCL-4, and ECP in the study group were significantly higher than those in the control group (P < 0.05). Serum IL-6, CCL-4, and ECP levels were significantly higher in the recurrence group than in the non-recurrence group (P < 0.05). ROC curve analysis showed that for predicting postoperative recurrence in patients with chronic sinusitis, the areas under the curve (AUC) for serum IL-6, CCL-4, and ECP were 0.768 (95% CI: 0.705, 0.822), 0.791 (95% CI: 0.731, 0.844), and 0.815 (95% CI: 0.755, 0.863), respectively. Sensitivities were 62.5% (95% CI: 0.538, 0.706), 77.94% (95% CI: 0.700, 0.846), and 67.65% (95% CI: 0.591, 0.754), respectively; specificities were 83.12% (95% CI: 0.729, 0.907), 74.03% (95% CI: 0.628, 0.834), and 80.52% (95% CI: 0.699, 0.887), respectively.Conclusion Serum levels of IL-6, CCL-4, and ECP are significantly elevated in patients with chronic sinusitis compared to healthy individuals and are associated with postoperative recurrence. Higher levels indicate a greater probability of recurrence. Early detection of serum IL-6, CCL-4, and ECP levels can effectively predict postoperative recurrence and provide a reference for early clinical preventive treatment.