口服糖皮质激素治疗阿司匹林不耐受鼻息肉  

Efficacy of a short course of oral corticosteroid in nasal polyps with aspirin intolerance

作　　者：王成硕[1] 娄鸿飞[1] 张罗[1,2] 

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科耳鼻咽喉头颈科学教育部重点实验室(首都医科大学),北京100730 [2]北京市耳鼻咽喉科研究所,北京100005

出　　处：《中国耳鼻咽喉头颈外科》2011年第12期631-633,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：国家杰出青年科学基金(81025007);国家自然科学基金项目(30872846和30973282);国家自然科学青年基金(81000405);北京市教委科技计划重点项目(KZ200910025008);北京市教委科技计划重点项目(KZ201110025027);北京市科技新星计划(2007B035)联合资助

摘　　要：目的探索口服甲泼尼龙短疗程治疗阿司匹林不耐受鼻息肉的疗效。方法入选24例嗜酸性粒细胞性鼻息肉伴阿司匹林不耐受患者。使用甲泼尼龙24 mg,1次/d,疗程为2周。治疗前后评价鼻堵、流涕、嗅觉、头面痛4个症状的视觉模拟量表(visual analogue scales,VAS)评分和内镜Davos评分。结果经过2周治疗后,鼻堵症状VAS评分的改善最为明显(治疗前8.57±0.63,治疗后3.93±0.79;t=19.89,P<0.0001),流涕症状的改善次之(治疗前8.33±0.94,治疗后4.38±1.09;t=17.03,P<0.0001),嗅觉症状改善又次之(治疗前8.96±0.62,治疗后5.83±2.31;t=7.80,P<0.0001),头痛症状的改善最不明显(治疗前5.31±1.46,治疗后4.02±0.88;t=4.38,P<0.001)。内镜下息肉Davos评分亦有明显减少[治疗前:5(4～5.37),治疗后:4(4～4);Z=3.57,P<0.0001]。结论短疗程使用甲泼尼龙治疗伴阿司匹林不耐受鼻息肉,可明显改善鼻部症状,减小息肉体积。可作为术前常规用药和术后长期控制息肉的有力手段。OBJECTIVE To evaluate the efficacy of a short course of oral methylprednisolone in nasal polyps with aspirin intolerance.METHODS Twenty four patients with aspirin sensitivity polyps received oral methylprednisolone（24 mg daily）for 2 weeks.Visual analogue scales（VAS）of nasal symptoms（including nasal obstruction,nasal discharge,loss of smell,and headache/facial pain）and endoscopic polyp scores（Davos scores） were performed to all the subjects before and after the treatment.RESULTS Oral methylprednisolone produced a significant improvement in all nasal symptoms especially nasal obstruction（baseline： 8.57±0.63,after treatment： 3.93±0.79,t=19.89,P〈0.0001）and reduced polyp size [baseline： 5（4-5.37）,after treatment： 4（4-4）,median with interquartile range,Z=3.57,P〈0.0001] compared with before treatment.CONCLUSION A short course of oral methylprednisolone improved nasal symptoms obviously and reduced polyp size.Based on these,we recommend short courses of oral methylprednisolone as pretreatment medication before endoscopic surgery and postreatment therapy to prevent and control recurrence of nasal polyp in patients with aspirin intolerance.

关 键 词：鼻息肉 阿司匹林 甲泼尼龙 糖皮质激素类 

分 类 号：R765.25[医药卫生—耳鼻咽喉科]