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——浙大迪迅 译

背景：烟曲霉特异性免疫球蛋白G（Af-sIgG）已被用于诊断过敏性支气管肺曲霉菌病，这是一种对真菌在下呼吸道定植的超敏反应。据报道，在上呼吸道，它与过敏性真菌性鼻窦炎和局部真菌性鼻窦炎有关。然而，在原发性慢性鼻窦炎（CRS）这一更常见的上呼吸道疾病中，Af-sIgG的作用尚不清楚。

目的：探讨血清Af-sIgG水平在原发性CRS患者中的作用。

方法：前瞻性地招募了诊断为双侧原发性CRS的患者和鼻中隔偏曲患者作为非CRS组。原发性CRS组的患者被进一步分为两种内型，包括2型（T2）和非T2组。采集的血清样本被送去进行Af-sIgG分析。分析了潜在因素和手术结果。

结果：招募了48名诊断为原发性CRS的患者（包括28名T2患者和20名非T2 CRS患者）和22名非CRS组患者。T2 CRS组的血清Af-sIgG水平显著高于非T2 CRS组（Af-sIg G高于27.6 mg/L的比值比为10.2；p＜0.001）。进一步的多变量logistic回归显示，血清Af-sIgG是原发性CRS患者一年内早期疾病复发的独立因素。血清Af-sIgG水平预测术后复发的最佳临界值为27.1mg/L（比值比15.1，p=0.013）。

结论：研究结果显示血清Af-sIgG水平是检测T2炎症和原发性CRS手术结果的实用标志物。通过应用这一可行的测试，我们可能能够为每一位原发性CRS患者实现最佳治疗。这项研究可能为医生未来在治疗原发性CRS方面的临床应用提供参考。

原始出处
Int. J. Med. Sci
Elevated Serum Aspergillus Fumigatus-Specific Immunoglobulin G in Type 2 Chronic Rhinosinusitis
DOI: 10.7150/ijms.83327
Abstract:
Background:Aspergillus fumigatus-specific immunoglobulin G (Af-sIgG) has been applied to diagnose allergic bronchopulmonary aspergillosis, a hypersensitivity reaction to the colonization of the fungus in the lower airways. In the upper airways, it has been reported to be involved in allergic fungal rhinosinusitis and local fungal rhinosinusitis. However, in primary chronic rhinosinusitis (CRS), a more common upper airway disease, the role of Af-sIgG remains unclear.
Objective: The aim of our study was to investigate the role of serum Af-sIgG levels in primary CRS patients.
Methods:We prospectively recruited patients diagnosed with bilateral primary CRS and patients with nasal septal deviation as the non-CRS group. Patients in the primary CRS group were further classified into two endotypes, including type 2 (T2) and non-T2 groups. Serum samples collected were sent for Af-sIgG analysis. Potential factors and surgical outcomes were analyzed.
Results:: Forty-eight patients with a diagnosis of primary CRS (including 28 with T2 and 20 with non-T2 CRS) and 22 patients in the non-CRS group were recruited. The T2 CRS group had significantly higher serum Af-sIgG levels than the non-T2 CRS group (odds ratio 10.2 with Af-sIgG more than 27.6 mg/L;p < 0.001). Further multivariate logistic regression showed that the serum Af-sIgG level was the independent factor for early disease recurrence within one year in primary CRS patients. The optimal cutoff value of the serum Af-sIgG level to predict postoperative recurrence was 27.1 mg/L (odds ratio 15.1, p = 0.013).
Conclusions:We suggest that the serum Af-sIgG level is a practical marker to detect T2 inflammation and the surgical outcome of primary CRS. By applying this feasible test, we may be able to achieve optimal treatment for every individual with primary CRS. This study may provide physicians with a reference for future clinical applications in dealing with primary CRS.
First Author:
Yun-Chen Chang
Corresponding author:
Chia-Hsiang Fu
Correspondence:
Division of Rhinology, Department of Otolaryngology-Head and Neck Surgery, Linkou Chang Gung Memorial Hospital and Chang Gung University, No. 5 Fu-Shin Street, Guishan District, Taoyuan City, 333, Taiwan.
E-mail: fufamily@adm.cgmh.org.tw.