Correlation Between Exhaled Nitric Oxide And Peripheral Blood Eosinophils And Its Significance In Patients With Chronic Rhinosinusitis

Objective: To investigate the correlation between exhaled nitric oxide(NO)and peripheral blood eosinophils(EOS)in patients with Chronic Rhinosinusitis(CRS)and its clinical significance,so as to provide reference basis for clinical prediction of CRS.Methods: 24 patients with chronic rhinosinusitis with nasal polyps(CRSwNP)and 24 patients with chronic rhinosinusitis without nasal polyps(CRSsNP)diagnosed by clinical and imaging examination in the Department of Otorhinolaryngology and head and neck surgery from November 10,2021 to February 10,2022 were collected as CRSsNP group,and 34 patients with simple nasal septum deviation(SMR)were collected as control group.Nasal expiratory nitric oxide(nNO),Fractional exhaled Nitric Oxide(FeNO),peripheral blood EOS count and EOS percentage were collected before operation.Kruskal-Wallis rank sum test was used to compare the differences between groups,Spearman correlation analysis was used to analyze the correlation,and the area under nNO and FeNO curves(area undercurve,AUC)were calculated by using the receiver operating characteristic(ROC)curve,and the curve characteristics,predictive value,specificity and sensitivity were analyzed,and the best cut-off value was determined.Results:1.The concentration of nNO in CRSwNP group,CRSsNP group and control group was 99.00(60.50-257.50)PPB,259.00(93.50-426.75)PPB and276.00(67.25-391.25)PPB;respectively.There was no significant difference in nNO concentration among the three groups.2.The concentration of FeNO in CRSwNP group,CRSsNP group and control group was 27.00(22.50-40.00)PPB,21.00(15.25-39.00)PPB and 17.00(11.75-26.00)PPB;CRSwNP group respectively,and the level of FeNO in PPB;CRSwNP group was significantly higher than that in control group.There was no significant difference in FeNO level between CRSwNP group and CRSsNP group,and there was no significant difference in FeNO level between CRSsNP group and control group.3.In CRSwNP group,FeNO was positively correlated with EOS count and EOS%,but nNO level was not correlated with EOS count and EOS%,FeNO level was not correlated with EOS count and EOS%.4.In CRSsNP group was not correlated with EOS count and EOS%,nNO level was not correlated with EOS count and EOS%.5.In the control group,there was no correlation between FeNO level and peripheral blood EOS count and EOS%,and there was no correlation between nNO level and peripheral blood EOS count and EOS%(P > 0.05).6.FeNO predicted the ROC curve of CRSwNP,the area under the curve was0.741(95%CI=0.610-0.873),the best cutoff value,sensitivity and specificity were 25.50,70.8% and 73.5%,respectively,while nNO had no clinical predictive value for CRSwNP.7.nNO and FeNO have no clinical predictive significance for CRSsNP.Conclusion:1.FeNO can be used as a low-cost and non-invasive clinical examination to evaluate and monitor the condition of CRSWw NP,and FeNO has moderate predictive value for CRSwNP.2.The level of FeNO in patients with CRSwN is positively correlated with peripheral blood EOS count and EOS%,and can be used as an index for evaluating eosinophilic inflammation of lower respiratory tract in CRSwNP.