鼻窦内窥镜术辅助低剂量克拉霉素治疗慢性鼻-鼻窦炎的疗效及对血清TIgE、ECP、炎性因子的影响  

Efficacy of endoscopic sinus surgery combined with low-dose clarithromycin in the treatment of chronic rhinosinusitis and its effect on serum TIgE,ECP and inflammatory factors

作　　者：余琳 毕瑞鹏 张卫杰 YU Lin;BI Ruipeng;ZHANG Weijie(Department of Otolaryngology,the Third People′s Hospital of Henan,Zhengzhou,Henan 450006,China)

机构地区：[1]河南省直第三人民医院耳鼻喉科,郑州450006

出　　处：《重庆医学》2018年第20期2689-2691,2694,共4页Chongqing medicine

摘　　要：目的分析鼻窦内窥镜手术(鼻内镜术)辅助低剂量克拉霉素治疗慢性鼻-鼻窦炎(CRS)的疗效及对血清总免疫球蛋白E(TIgE)、嗜酸性粒细胞阳离子蛋白(ECP)、炎性因子的影响。方法选取2016年1月至2017年1月在该院治疗的56例CRS患者分为两组,每组28例。常规组患者采用鼻内镜术与常规抗菌药物治疗,观察组患者在常规组基础上辅助低剂量克拉霉素治疗。分析两组患者治疗的疗效及血清TIgE、ECP、炎性因子水平变化。结果治疗后,观察组患者总有效率为92.85%,高于常规组的71.43%(χ~2=4.383,P=0.036),同时患者流涕、鼻塞、头痛、嗅觉减弱及面部疼痛各症候积分低于常规组,且组内比较差异有统计学意义(P<0.05)。观察组患者TIgE、ECP、炎性因子肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-1β、IL-6、IL-8水平及Lund-kennedy评分均低于常规组,且组内比较差异有统计学意义(P<0.05)。结论鼻内镜术辅助低剂量克拉霉素抗炎作用显著,明显改善慢性鼻-鼻窦炎的疗效。Objective To analyze the efficacy of sinus endoscopic surgery(nasal endoscopy)assisted low-dose clarithromycin in the treatment of chronic rhinosinusitis(CRS)and serum total immunoglobulin E(TIgE),eosinophil cationic protein(ECP),the influence of inflammatory factors.Methods A total of 56 patients with CRS who were treated in this hospital between January 2016 and January 2017 were selected.Divided the patients into two groups,28 cases in each group.The patients in the conventional group were treated with endoscopic surgery and antibiotics,and the patients in the observation group were assisted with low-dose clarithromycin treatment on the basis of the conventional group.The efficacy of treatment and serum levels of TIgE,ECP,and inflammatory factors were analyzed.Results After treatment,the total effective rate was 92.85%in the observation group,which was higher than 71.43%in the conventional group(χ2=4.383,P=0.036).Compared with the conventional group,the scores of runny nose,nasal congestion,headache,olfactory sensation,and facial pain were lower,there was statistical significant difference between the two groups(P<0.05);the TIgE,ECP,tumor necrosis factor-α(TNF-α),interleukin(IL)-1β,IL-6,IL-8 levels and Lund-kennedy scores in the observation group were lower,there was statistical significant difference between the two groups(P<0.05).Conclusion Nasal endoscopy assisted low-dose clarithromycin has significant anti-inflammatory effects,and it improves the efficacy of chronic rhinosinusitis.

关 键 词：克拉霉素 慢性鼻-鼻窦炎 鼻内镜术 总免疫球蛋白E 嗜酸性粒细胞阳离子蛋白 炎性因子 

分 类 号：R856.76[医药卫生—航空、航天与航海医学]