两性霉素B联合内镜手术对真菌性鼻-鼻窦炎患者炎症反应及免疫功能的影响  

Effect of amphotericin B combined with endoscopic surgery on inflammatory response and immune function in patients with fungal rhinosinusitis

作　　者：杨绿原[1] 黄江菊[1,2] 

机构地区：[1]太原市妇幼保健院耳鼻咽喉科,太原030000 [2]重庆医科大学附属第一医院耳鼻喉科,重庆400016

出　　处：《中国临床药理学杂志》2016年第2期102-104,共3页The Chinese Journal of Clinical Pharmacology

基　　金：重庆市科技计划项目基金资助项目(CSTC2013YYKFA110005)

摘　　要：目的观察两性霉素B联合内镜手术对真菌性鼻-鼻窦炎(FRS)患者炎症反应及免疫功能的影响。方法入选104例进行两性霉素B联合内镜手术治疗的FRS患者为试验组,并随机选取104例健康志愿者为对照组。试验组予以4μg·m L^(-1)两性霉素B冲洗鼻腔,每天1次,持续4周。对照组不进行手术或治疗处理。观察试验组的临床疗效,以及术前、术后与对照组的血清白细胞介素-4(IL-4)、IL-6、IL-12、IL-17、脂蛋白a、超敏C反应蛋白、淋巴细胞总数、CD3^+、CD4^+、CD8^+、CD19^+、免疫球蛋白G(IgG)、Ig M的水平。结果术后,试验组达到治愈者96例(92.31%),有效者8例(7.69%)。术前,试验组的血清IL-4、IL-6、IL-12、IL-17、脂蛋白a、超敏C反应蛋白等指标水平均明显高于对照组(P<0.01);术后,试验组的IL-4、IL-12、超敏C反应蛋白明显高于对照组(P<0.01),IL-6、IL-17、脂蛋白a与对照组比较差异无统计学意义(P>0.05)。术前,试验组的淋巴细胞总数、CD3^+、CD4^+、CD8^+、IgG等均显著低于对照组(P<0.01);术后,试验组的上述指标较术前均明显提高(P<0.01),但仍然显著低于对照组(P<0.01)。2组的CD19^+、Ig M指标比较差异无统计学意义(P>0.05)。结论两性霉素B联合内镜手术有助于改善FRS患者的炎性反应和免疫功能。Objective To investigate the effect of amphotericin B combined with endoscopic surgery on inflammatory response and immune function in patients with fungal rhinosinusitis（ FRS）. Methods One hundred and four cases of patients with FRS treated with amphotericin B combined with endoscopic surgery were selected as treatment group. And 104 cases of healthy volunteers were randomly selected as control group.Patients in treatment group were treated with 4 μg·mL^-1 amphotericin B for nasal wash,once every day for 4 weeks. Patients in control group received no surgery or treatment. In treatment group before and after surgery,serum interleukin 4（ IL- 4）,IL- 6,IL- 12,IL- 17,lipoprotein（ a） [Lp（ a） ], high- sensitivity C- reactive protein（ hs- CRP）,total lymphocyte count,CD3^＋,CD4^＋,CD8^＋,CD19^＋,immunoglobulin G（ IgG） and IgM levels were detected. Results After surgery,96 cases in treatment group achieved cure（ 92. 31%）,8 cases had no effect（ 7. 69%）. In treatment group before surgery, serumIL- 4,IL- 6,IL- 12,IL- 17,Lp（ a）,hs- CRP levels were significantly higher than those in control group（ P〈0. 01）. After surgery,IL- 4,IL- 12 and hs- CRP in treatment group were significantly higher than those in control group（ P〈0. 01）,and without significant difference in comparison of IL- 6,IL- 17 and Lp（ a）（ P〉0. 05）. Before surgery,total lymphocyte count,CD3^＋,CD4^＋,CD8^＋and IgG in treatment group were significantly lower than those in control group,while theses indexes significantly increased after surgery（ P〈0. 01）,but significantly lower than that in control group（ P〈0. 01）. In comparison of CD19^＋and IgM between the two groups,there was no significant difference（ P〉0. 05）. Conclusion Amphotericin B combined with endoscopic surgery helped to improve inflammatory response and immune function in patients with FRS.

关 键 词：两性霉素B 内镜 真菌性鼻-鼻窦炎 炎症反应 免疫功能 

分 类 号：R978.1[医药卫生—药品] R969.4[医药卫生—药学]