山东大学耳鼻喉眼学报 ›› 2024, Vol. 38 ›› Issue (4): 43-54.doi: 10.6040/j.issn.1673-3770.0.2024.093
• 论著 • 上一篇
陈兴雪,张广玲,武天义,王卫卫,孙占伟,李世超,王广科
CHEN Xingxue, ZHANG Guangling, WU Tianyi, WANG Weiwei, SUN Zhanwei, LI Shichao, WANG Guangke
摘要: 目的 比较分析抗IL-4Rα单克隆抗体、鼻内镜手术(endoscopic sinus surgery, ESS)治疗嗜酸性粒细胞型慢性鼻窦炎伴鼻息肉(eosinophilic chronic rhinosinusitis with nasal polyps, ECRSwNP)的短期疗效。 方法 21例双侧ECRSwNP患者分别接受ESS治疗(手术组)、单克隆抗体治疗(单抗组)及鼻用糖皮质激素(对照组)治疗。观察各组在治疗后1、3、6个月各项主观及客观评分基线的差异,评价两种治疗方式的治疗效果。 结果 单抗组和手术组治疗后6个月鼻内镜评分(nasal polyps score,NPS)、鼻腔鼻窦结局测试22条(sino-nasal outcome test-22, SNOT-22)评分、SNOT-22鼻塞评分、嗅觉评分、Lund-Mackay评分与基线对比,差异均具有统计学意义(P均<0.05)。治疗后6个月单抗组和手术组间NPS评分(P=0.02)差异具有统计学意义,SNOT-22评分(P=0.57)、鼻塞评分(P=0.94)、嗅觉评分(P=0.11)及Lund-Mackay评分(P=0.08)差异无统计学意义。单抗组和手术组哮喘患者FEV1%(P=0.04)、FEV1/FVC(P=0.01)治疗前后差异有统计学意义,两组间差异无统计学意义(P=0.25,P=0.74)。三组患者嗜酸性粒细胞计数(F=1.73, P=0.21)及嗜酸性粒细胞百分比(F=0.03,P=0.87)治疗前后变化差异无统计学意义,三组间差异无统计学意义(P=0.18,P=0.07)。 结论 抗IL-4Rα单克隆抗体和鼻内镜手术均可显著改善ECRSwNP患者鼻部症状、嗅觉水平以及肺功能,缩小鼻窦炎病变范围,提高患者生活质量。抗IL-4Rα单克隆抗体患者的嗅觉改善更明显,ESS患者的息肉负担减少、鼻部症状改善更显著。
中图分类号:
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