山东大学耳鼻喉眼学报 ›› 2015, Vol. 29 ›› Issue (4): 42-44.doi: 10.6040/j.issn.1673-3770.0.2014.414

• 论著 • 上一篇    下一篇

扁桃体切除术对变应性鼻炎合并支气管哮喘的影响

王贵锋, 方文豪, 潘金斌, 魏茂彬, 王晓杰, 李云霞   

  1. 解放军第401医院北院耳鼻咽喉头颈外科, 山东 青岛 266100
  • 收稿日期:2014-12-25 修回日期:2015-06-11 出版日期:2015-08-16 发布日期:2015-08-16
  • 作者简介:王贵锋。E-mail:wggfff@126.com

Evidences from clinical epidemiological survey for allergic rhinitis patients complicated by bronchial asthma after tonsillectomy.

WANG Guifeng, FANG Wenhao, PAN Jinbin, WEI Maobin, WANG Xiaojie, LI Yunxia   

  1. Department of Otorhinolaryngology, The 401 st Hospital of Chinese PLA, Qingdao 266100, Shandong, China
  • Received:2014-12-25 Revised:2015-06-11 Online:2015-08-16 Published:2015-08-16

摘要: 目的 探讨变应性鼻炎行扁桃体切除后患者并发支气管哮喘的情况。方法 将解放军第401医院北院耳鼻咽喉头颈外科1990年至2000年有详细资料的变应性鼻炎患者分为扁桃体切除组和非扁桃体切除组, 采用问卷的方式调查变应性鼻炎的程度、并发支气管哮喘的首发年龄、支气管哮喘的发病程度及自行用药的控制程度等。结果 共调查变应性鼻炎患者1 249例, 其中扁桃体切除组128例, 46.88%的变应性鼻炎为轻度, 哮喘发生率为32.03%, 首发年龄为(32.40±7.63)岁, 中重度哮喘发病率为43.90%, 哮喘患者自行用药控制率达82.93%;非扁桃体切除组1 121例, 18.20%的变应性鼻炎为轻度, 哮喘发生率为47.55%, 首发年龄为(19.88±6.39)岁, 中重度哮喘发病率为43.90%, 哮喘患者自行用药控制率达68.10%。两组差异有统计学意义(P均<0.05 )。结论 扁桃体切除术对变应性鼻炎并发支气管哮喘有一定的治疗作用。

关键词: 变应性鼻炎, 支气管哮喘, 扁桃体, 免疫反应

Abstract: Objective To explore the effect of tonsillectomy on patients with allergic rhinitis complicated with asthma. Methods A survey about allergic rhinitis severity, asthma starting age, disease severity and the medication control by patients themselves who were treated in the department of otorhinolaryngology, the 401 st hospital of PLA from 1990 to 2000 was carried out. Results A total of 1 249 allergic rhinitis patients completed the survey. The patients were divided into two groups: the tonsillectomy group(n=128) and the non-tonsillectomy group(n=1 121). Of the tonsillectomy group, the longitudinal allergic rhinitis rate was 46.88%, coucurrent asthma rate was 32.03%, asthma starting age was (32.4±7.63) years, moderate incidence rate of asthma was 43.9% and remission rate of asthma with drugs was 82.93%. Of the non-tonsillectomy group, the longitudinal allergic rhinitisrate was 18.20%, coucurrent asthma rate was 47.55%, asthma starting age was (19.88±6.39) years, moderate incidence rate of asthma was 43.90% and remission rate of asthma with drugs was 68.10%.The difference was statistically significant between the two groups(all P<0.05). Conclusion The tonsillectomy has a therapeutic effect on allergic rhinitis complicated with asthma.

Key words: Immune response, Allergic rhinitis, Asthma, Tonsil

中图分类号: 

  • R765.21
[1] 中华耳鼻咽喉头颈外科杂志编委会鼻科组, 中华医学会耳鼻咽喉头颈外科学分会鼻科组.变应性鼻炎诊断和治疗指南(2009, 武夷山)[J]. 中华耳鼻咽喉头颈外科杂志, 2009, 44(12):977-978. Nasal Study Group of Editorial Board of the Chinese Journal of Otorhinolaryngology Head and Neck Surgery. Nasal Study Group of Chinese Medical Association of Otorhinolaryngology Head and Neck Surgery. Guidelines of diagnois and treatment for allergic rhinitis(2009, Wuyishan)[J]. Chin J Otorhinolaryngol Head Neck Surg, 2009, 44(12):977-978.
[2] 中华医学会呼吸系分会哮喘学组.支气管哮喘防治指南(支气管哮喘的定义、诊断、治疗和管理方案)[J]. 中华哮喘杂志:电子版, 2008, 2(1):3-13. Asthma Group of the Respiratory Disease Branch of Chinese Medical Association. Guidelines for the prevention and treatment of bronchial asthma: the definition, dianosis, treatment and management program[J]. Chin J Asth, 2008, 2(1):3-13.
[3] Bhattacharjee R, Choi B H, Gozal D, et al. Associaton of adenotonsillectomy with asthma outcomes in children: a longitudinal database anslysis[J]. PLOS Med, 2014, 11(1):1-12.
[4] 韩德民. 鼻部疾病和支气管哮喘[J]. 哮喘杂志, 2000, 6(1):53-57. HAN Demin. Nasal disease and bronchial asthma[J]. Asthma, 2000, 6(1):53-57.
[5] Togias A. Rhinitis and asthma:evidence for respiratory system integtation[J]. J Allergy Clin Immunol, 2003, 111(6):1171-1184.
[6] 文昭明. 呼吸系统变态反应疾病诊断治疗学[M]. 北京:中国协和医科大学出版社, 2002: 2-3.
[7] 张金花, 周怡, 刘宇. 内源性哮喘免疫支持治疗的探讨[J]. 中国现代医学杂志, 2007, 17(4):464-466. ZHANG Jinhua, ZHOU Yi, LIU Yu. Discussion of immutherapy to patients with intrinsic asthma[J]. Chin J Modern Med, 2007, 17(4):464-466.
[8] 杨珍, 张莉. 扁桃体免疫功能研究进展[J]. 内蒙古医学院学报, 2006, 28(3):240-242. YANG Zhen, ZHANG Li . The research progress of immune function of the tonsils[J]. Acta Acad Med Neimongol, 2006, 28(3):240-242.
[9] 闵密克, 陈丽华, 金伯泉, 等. 腭扁桃体中几种杀伤功能相关分子的表达[J]. 临床军医杂志, 2010, 38(5):785-787. MIN Mike, CHEN Lihua, JIN Boquan, et al. Expression and distribution of several cytotoxicity associated molecules in palatine tonsil[J]. Clin J Med Off, 2010, 38(5):785-787.
[10] 张涛, 丁勇, 王继群, 等. 扁桃体组织中白细胞介素-4的表达和意义[J]. 中国病理生理杂志, 2000, 16(2):112-114. ZHANG Tao, DING Yong, WANG Jiqun, et al. The expression and effect of IL-4 in human palatine tonsil[J]. Chin J Pathophysiol, 2000, 16(2):112-114.
[11] 杨珍. 扁桃体组织中IL- 4与 IL- 5的表达和意义[J]. 内蒙古医学杂志, 2011, 33(4):322-324. YANG Zhen. The clinical significance of expressions of IL-4 and IL-5 in palatine tonsil[J]. Inner Mongolia Med J, 2011, 33(4):322-324.
[12] 罗蓉, 孔维佳, 黄翔, 等. 慢性扁桃体炎患者外周血T淋巴细胞亚群的分析与临床意义[J].临床耳鼻咽喉头颈外科杂志, 2009, 23(10):436-442. LUO Rong, KONG Weijia, HUANG Xiang, et al. Peripheral T cell subsets in chronic tonsillitis patients[J]. J Clin Otorhinolaryngol Head Neck Surg, 2009, 23(10):436-442.
[13] 黄宇勇, 黄晓华, 徐浩文. 手术治疗对慢性扁桃体炎患者细胞免疫功能的影响[J].临床耳鼻咽喉头颈外科杂志, 2011, 25(4):182-183. HUANG Yuyong, HUANG Xiaohua, XU Haowen. Operation treatment effect on immune cells in patients with chronic tonsillitis function[J]. Clin Otolaryngol Head Neck Surg, 2011, 25(4):182-183.
[14] 杨勇, 陈宗波. 反复扁桃体炎患儿缓解期T细胞亚群及辅助性T淋巴细胞亚群的功能状态[J].实用儿科临床杂志, 2006, 21(4):222-223. YANG Yong, CHEN Zongbo. Study on T- cell and T- helper cell subpopulation function in children with recurrent tonsillitis in remission period[J]. J App Clin Pedia, 2006, 21(4):222-223.
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