糖皮质激素短疗程雾化吸入对嗜酸粒细胞性鼻窦炎伴鼻息肉患者鼻部症状及肾上腺皮质功能的影响

doi:10.6040/j.issn.1673-3770.0.2017.170

摘要/Abstract

摘要： 目的探讨糖皮质激素短疗程雾化吸入对嗜酸粒细胞性鼻窦炎伴鼻息肉患者鼻部症状及肾上腺皮质功能的影响。方法将嗜酸粒细胞性慢性鼻窦炎伴鼻息肉患者40例,以随机数字表法分为对照组(20例)和观察组(20例),分别给予糖皮质激素短疗程喷鼻和雾化吸入方案治疗。比较两组患者近期疗效,治疗前后鼻部症状VAS评分,内镜Lund-Kennedy评分,嗜酸性粒细胞绝对值(EOS)计数水平、血清皮质醇水平及随访复发率等。结果观察组患者治疗显效率和总有效率均高于对照组(P<0.05);观察组患者治疗后鼻部症状VAS评分和内镜Lund-Kennedy评分均低于对照组及本组治疗前(P<0.05);观察组患者随访3个月和6个月复发率均低于对照组(P<0.05);观察组患者治疗后EOS计数水平均低于对照组及本组治疗前(P<0.05);同时两组患者治疗前后血清皮质醇水平比较差异无统计学意义(P>0.05)。结论相较于喷鼻方案,糖皮质激素短疗程雾化吸入方案治疗嗜酸粒细胞性鼻窦炎伴鼻息肉可有效缓解鼻部症状体征,抑制嗜酸性粒细胞聚集,降低远期复发风险,且未对肾上腺皮质功能产生明显影响。

关键词: 糖皮质激素, 慢性鼻窦炎, 雾化吸入, 嗜酸性粒细胞, 鼻息肉

Abstract: Objective The aim of this study was to investigate the effect of short-term glucocorticoid inhalation on nasal symptoms and adrenocortical function in patients with both eosinophilic chronic sinusitis and nasal polyps. Methods A total of 40 patients with eosinophilic chronic sinusitis with nasal polyps were enrolled from June 2013 to June 2016 in the hospital, and they were randomly divided into two groups: one control group(20 patients)with glucocorticoid treatment by nasal spray and one observation group(20 patients)with glucocorticoid treatment by inhalation. The short-term clinical efficiency, visual analogue scale(VAS)scores of nasal symptoms, Lund-Kennedy endoscopic score, eosinophil(EOS)count, and serum cortisol concentration were compared between these two groups before and after treatment. The follow-up recurrence rate in both groups was also investigated. Results The clinical excellence and overall efficiency were significantly higher in the observation group than in the control group(P<0.05). The VAS scores of nasal symptoms and Lund-Kennedy endoscopic score were significantly lower in the observation group than in the control group after treatment, and the observation group also showed significantly decreased aforementioned scores after treatment compared with before treatment(P<0.05). The follow-up recurrence rates in 3 months and 6 months were significantly lower in the observation group than in the control group(P<0.05). EOS count was significantly lower in the observation group than in the control group after treatment, and the observation group also showed significantly reduced EOS count after treatment compared with before treatment(P<0.05). No significant differences in serum cortisol concentration were observed between these two groups both before and after treatment(P>0.05). Conclusion Compared with glucocorticoid treatment by nasal spray, glucocorticoid treatment by inhalation can significantly relieve nasal symptoms, inhibit the aggregation of eosinophils, and reduce the long-term recurrence risk, but the inhalation treatment has no significant effects on the adrenocortical function in patients with both eosinophilic chronic sinusitis and nasal polyps.

Key words: Glucocorticoid, Chronic sinusitis, Inhalation, Nasal polyps, Eosinophil

中图分类号:

R765.4

黄凯丰. 糖皮质激素短疗程雾化吸入对嗜酸粒细胞性鼻窦炎伴鼻息肉患者鼻部症状及肾上腺皮质功能的影响[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 28-31.

Effect of short-term glucocorticoid inhalation on nasal symptoms and adrenocortical function in patients with eosinophilic chronic sinusitis accompanied by nasal polyps. Effect of short-term glucocorticoid inhalation on nasal symptoms and adrenocortical function in patients with eosinophilic chronic sinusitis accompanied by nasal polyps[J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32(4): 28-31.

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