JESREC评分、代谢因素与肺功能障碍：成人慢性鼻窦炎患者中的分析
JESREC score, metabolic factors, and pulmonary dysfunction: analysis among adult patients with chronic rhinosinusitis.
文献信息
| PMID | 42798609 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Ling Zhang |
| 作者单位 | Department of Otorhinolaryngology, The First People's Hospital of Changzhou, The Third Affiliated Hospital of Soochow University, Soochow University, Changzhou, China. |
| 期刊 | Frontiers in medicine |
| SCI 分区 | Q1 |
| IF | 3.7 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景： 慢性鼻窦炎（CRS），尤其是其嗜酸性粒细胞型（ECRS），常与下气道疾病共存。JESREC评分是一种用于预测ECRS的临床工具。本研究旨在评估成人CRS患者中JESREC评分与肺功能障碍之间的关联，并探讨代谢因素的潜在作用。
方法： 根据肺功能检查对患者进行分类，并进行多因素logistic回归分析，以确定与整体肺功能障碍及其限制性和阻塞性亚型相关的因素。使用受试者工作特征（ROC）曲线分析评估JESREC评分的判别能力。此外，构建中介模型以探究代谢因素（BMI、血压、空腹血糖和血清脂质组学特征）的中介作用。
结果： 最终分析共纳入143例患者。肺功能障碍患者的JESREC评分显著更高（8.6 vs. 5.0，P < 0.001）。多因素分析证实JESREC评分（OR，1.24，95% CI，1.12-1.37）和ECRS（5.17，2.05-13.09）是肺功能障碍（包括限制性和阻塞性亚型）的相关因素。ROC曲线显示AUC为0.729，最佳JESREC截断值为4.5。中介分析表明，收缩压、舒张压、甘油三酯和HDL-C分别显著中介了总效应的6.4%、4.5%、8.4%和6.5%。
结论： JESREC评分与CRS患者的肺功能障碍独立相关，代谢因素可能在统计学上中介了这种关联的一部分，提示存在潜在通路。此外，JESREC评分≥5的患者可能需要特别关注肺功能。
英文摘要
BACKGROUND: Chronic Rhinosinusitis (CRS), particularly its eosinophilic endotype (ECRS), is frequently associated with comorbid lower airway diseases. The JESREC score is a clinical tool for predicting ECRS. This study aimed to evaluate the association between the JESREC score and pulmonary dysfunction in adult CRS patients and to explore the potential role of metabolic factors.
METHODS: Patients were categorized based on pulmonary function tests and multivariate logistic regression analyses were performed to identify associated factors for overall pulmonary dysfunction and its restrictive and obstructive subtypes. The discriminative ability of the JESREC score was evaluated using Receiver Operating Characteristic (ROC) curve analysis. Furthermore, mediation models were constructed to figure out the mediating role of metabolic factors (BMI, blood pressure, fasting blood glucose and serum lipidomic profiles).
RESULTS: A total of 143 patients were included in the final analysis. The JESREC score was significantly higher in patients with pulmonary dysfunction (8.6 vs. 5.0, P < 0.001). Multivariate analysis confirmed the JESREC score (OR, 1.24, 95% CI, 1.12-1.37) and ECRS (5.17, 2.05-13.09) as associated factors for pulmonary dysfunction, including both restrictive and obstructive subtypes. The ROC curve showed an AUC of 0.729, with an optimal JESREC cutoff of 4.5. Mediation analysis indicated that systolic blood pressure, diastolic blood pressure, triglycerides, and HDL-C significantly mediated 6.4%, 4.5%, 8.4%, and 6.5% of the total effect, respectively.
CONCLUSIONS: JESREC score was independently associated with pulmonary dysfunction in CRS patients, and metabolic factors may statistically mediate part of this association, suggesting a potential pathway. Furthermore, patients with JESREC score ≥ 5 may warrant special attention to pulmonary function.