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慢性鼻-鼻窦炎术后应用曲安奈德喷鼻治疗疗效及对鼻黏膜IL 17及Eos浸润的影响
赵耀新,李静远,张建中,周艺仪
0
(广州医科大学附属第五医院耳鼻咽喉头颈外科)
摘要:
【摘要】 目的 观察慢性鼻鼻窦炎(CRS)术后应用曲安奈德喷鼻治疗疗效及对鼻黏膜白介素17(IL17)及嗜酸性粒细胞(Eos)浸润的影响。方法 选取2013年2月~2017年2月我院收治的接受鼻内镜手术治疗CRS患者380例,按照随机抽签法分为对照组和观察组各190例。对照组术后使用生理盐水灌洗患者鼻腔,观察组术后使用曲安奈德进行喷鼻治疗。比较两组术后7d与治疗1疗程后视觉模拟(VAS)各症状评分、鼻腔鼻窦结局测试20(SNOT20)评分、鼻黏膜纤毛传送率(MTR)、鼻黏膜白介素6(IL6)、白介素8(IL8)、白介素17(IL17)表达水平和Eos计数及不良反应率。结果 1疗程后,观察组鼻黏膜IL6、IL8、IL17阳性细胞率、Eos计数均明显低于对照组(P<005),鼻黏膜MTR明显大于对照组(P<005);观察组VAS各症状评分及SNOT20各项内容评分均明显低于对照组(P<005);两组不良反应率差异无统计学意义(P>005)。结论 CRS术后应用曲安奈德进行治疗,可有效降低患者鼻黏膜炎性因子水平,减小Eos浸润程度,提高鼻黏膜MTR,改善其临床症状及生活质量,且不良反应少。
关键词:  慢性鼻-鼻窦炎  手术  曲安奈德  白介素17  嗜酸性粒细胞
DOI:
基金项目:
Efficacy of triamcinolone acetonide nasal therapy after chronic rhinosinusitis surgery and its effects on the nasal mucosa IL 17 and eos infiltration
ZHAO Yaoxin,LI Jingyuan,ZHANG Jianzhong,ZHOU Yiyi
(Department of Otolaryngology Head and Neck Surgery, The Fifth Affiliated Hospital of Guangzhou Medical University)
Abstract:
【Abstract】 Objective To observe the efficacy of triamcinolone acetonide nasal therapy after chronic rhinosinusitis (CRS) and its effects on nasal mucosa interleukin 17 (IL17) and eosinophil (Eos) infiltration. Methods 380 patients treated with endoscopic sinus surgery for CRS from February 2013 to February 2017 were included in the study and divided into control group and observation group with 190 cases in each group by the random lottery method. The control group was treated with normal saline irrigation for nasal cavity, and the observation group was given triamcinolone acetonide nasal therapy after operation. The visual analogue scale (VAS) symptom scores, nasal outcome test20 (SNOT20) score, mucociliary transmission rate (MTR) and the expression levels of nasal mucosa interleukin 6 (IL6), interleukin 8 (IL8), interleukin 17 (IL17), and Eos count and the incidence rate of adverse reactions were compared between the 2 groups at 7d t after treatment and 1 course of treatment. Results The positive rates of nasal mucosa IL6, IL8, IL17 and Eos count were significantly lower in the observation group than those in the control group (P<005), and the nasal mucosa MTR level was significantly higher than that of the control group (P<005). The scores of VAS all symptoms and SNOT20 in the observation group were significantly lower than those in the control group (P<005). There was no significant difference between the two groups in the incidence rate of adverse reactions (P>005). Conclusion Triamcinolone acetonide after CRS can effectively reduce the nasal mucosal inflammatory factors levels and the degree of Eos infiltration, and improve the nasal mucosa MTR, clinical symptoms and quality of life with less adverse reactions.
Key words:  Chronic rhinosinusitis  Surgery  Triamcinolone acetonide  Interleukin 17  Eosnophils

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