前组筛窦开放联合下鼻甲激光消融术对变应性鼻炎患者血清IgE、IgG、ECP水平的影响  

Effects of the combined therapy with anterior ethmoidectomy and inferior turbinate laser ablation on serum levels of total IgE, IgG and ECP among patients with allergic rhinitis

作　　者：张燚[1] 陈晓平[2] 陈群[2] 张竞飞[2] 

机构地区：[1]宁夏医学院,2005级硕士研究生银川750004 [2]上海市浦东新区公利医院耳鼻咽喉科

出　　处：《中国中西医结合耳鼻咽喉科杂志》2008年第2期92-95,共4页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的观察比较前组筛窦开放术联合下鼻甲激光消融术治疗前后变应性鼻炎患者血清IgE、IgG、嗜酸性粒细胞阳离子蛋白(ECP)水平的变化,探讨该疗法治疗变应性鼻炎的机制。方法20例变应性鼻炎患者,经鼻内镜行前组筛窦开放术联合下鼻甲激光消融术;术前、术后1、2、4周分别检测患者血清总IgE(tIgE)、IgG、ECP水平,并以20例健康者作为对照组。结果与健康对照组相比较,手术治疗前变应性鼻炎患者的tIgE和ECP水平均明显升高,差异具有统计学意义(P<0.05)。与患者本身术前水平相比较,手术治疗后1、2周时,其tIgE、IgG和ECP水平变化差异均无统计学意义(P>0.05);至手术治疗后4周时,其tIgE和ECP水平均低于术前,IgG又高于术前,差异具有统计学意义(P<0.05)。直线相关分析显示,tIgE与ECP水平存在高度正相关(r=0.943,P=0.001)。结论前组筛窦开放术联合下鼻甲激光消融术治疗变应性鼻炎的机制,可能是破坏筛前神经和部分副交感神经末梢,阻断神经反射,减少神经肽的释放,进而调节血清IgE、IgG、ECP的水平而发挥治疗作用。Objective To investigate the effects of the combined therapy with anterior ethmoidectomy and inferior turbinate laser ablation on serum levels of total IgE, IgG and eosinophil cationic protein （ECP） among patients with allergic rhinitis to explore its mechanism underlying the therapeutic effect on this kind of lesion. Methods Included in this study were 20 cases with allergic rhinitis treated by a combined therapy with anterior ethmoidectomy and inferior turbinate laser ablation under nasal endoscope, with 20 healthy people taken as normal controls. Then, their serum levels of tIgE, IgG and ECP were determined before the operation and at the first postoperative week, second week and fourth week respectively to analyze their changes following the therapy. Results When compared with that of healthy controls, the levels of tIgE and ECP in allergic rhinitis patients were significantly elevated before the treatment given, with significant differences among them （P〈0.05）, while there was no such significant differences present in the serum levels of tlgE, IgG and ECP in these cases at the first week and the second week postoperatively when compared these values with their own levels determined before the operation （P〉0.05）. However, the serum levels of tlgE and ECP were significantly lowered and that of IgG was markedly elevated at the fourth postoperative week, when compared with their own values determined preoperatively （P〈0.05）. Moreover, there was also a significantly positive correlation seen in the serum level of tIgE with that of ECP among these cases （r=0.943,P=0.001） following a linear correlative analysis. Conclusions As suggested from the results of this study, the therapeutic mechanisms of the combined therapy with anterior ethmoidectomy and inferior turbinate laser ablation may be that to regulate the serum levels of IgE, IgG and ECP through destroying the endings of ethmoidal nerve and part of parasympathetic nervous fibril to block the neural reflexes so as to decrease the rele

关 键 词：变应性鼻炎 前组筛窦开放术 下鼻甲激光消融术 疗效 机制 

分 类 号：R765[医药卫生—耳鼻咽喉科]