低剂量克拉霉素联合鼻内镜下鼻中隔矫正术及鼻窦开放术对慢性鼻-鼻窦炎患者治疗效果及ECP TIgE水平的影响  

Effect of Low-dose Clarithromycin combined with Endoscopic Nasal Septum Correction and Sinus Opening for Chronic Rhinosinusitis Patients with ECP and TIgE Levels

作　　者：李东波[1] 韩锦华[1] 高伟[1] LI Dongbo;HAN Jinhua;GAO Wei(Xinhua Hospital Affiliated to Dalian College, Liaoning Dalian 116021, China)

机构地区：[1]大连大学附属新华医院耳鼻咽喉科

出　　处：《河北医学》2019年第6期881-886,共6页Hebei Medicine

基　　金：辽宁省自然科学基金项目,(编号:201402025)

摘　　要：目的:探讨低剂量克拉霉素联合鼻内镜下鼻中隔矫正术及鼻窦开放术对慢性鼻-鼻窦炎(CRS)患者治疗效果及血清嗜酸性粒细胞阳离子蛋白(ECP)、总免疫球蛋白E(TIgE)水平的影响。方法:选取2016年2月至2018年4月我院CRS患者124例,依据简单随机分组法分为对照组(n=62)、试验组(n=62)。对照组采取鼻内镜下鼻中隔矫正术及鼻窦开放术治疗,试验组采取低剂量克拉霉素联合鼻内镜下鼻中隔矫正术及鼻窦开放术治疗。比较两组术后3个月治疗效果与术前、术后1个月、术后3个月血清ECP、TIgE水平、炎症因子指标[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平、生活质量评分(SF-36)。结果:试验组术后3个月总有效率93.55%较对照组70.97%高,差异有统计学意义(P<0.05);两组术后1个月、3个月血清ECP、TIgE、IL-6、TNF-α水平均呈降低趋势,且试验组上述血清指标水平降低幅度较大,两组血清ECP、TIgE、IL-6、TNF-α水平组间、不同时间点及组间·不同时间点交互作用比较,差异有统计学意义(P<0.05);两组术后1个月、3个月SF-36评分呈增高趋势,且试验组SF-36评分增高幅度较大,两组SF-36评分组间、不同时间点及组间·不同时间点交互作用比较,差异有统计学意义(P<0.05)。结论:对慢性鼻-鼻窦炎患者采取低剂量克拉霉素联合鼻内镜下鼻中隔矫正术及鼻窦开放术治疗可提升治疗效果,降低血清ECP、TIgE水平,减轻机体炎症反应,提高患者生活质量。Objective: To investigate the therapeutic effect of low-dose clarithromycin combined with endoscopic nasal septum correction and sinus open surgery on chronic rhinosinusitis (CRS) patients and serum eosinophil cationic protein (ECP) and total immunoglobulin E(TIgE) levels. Methods: From February 2016 to April 2018, 124 patients with CRS in our hospital were selected and divided into control group (n=62) and experimental group (n=62) according to simple randomization. The control group underwent endoscopic nasal septum correction and sinus open surgery. The test group was treated with low-dose clarithromycin combined with endoscopic nasal septum correction and sinus open surgery. The therapeutic effects of the two groups after surgery were compared with those of preoperative, postoperative, 1 month, and 3 months postoperative serum ECP, TIgE levels, and inflammatory factors [interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α)] level, quality of life score (SF-36). Results: The total effective rate of the test group was 93.55% at 3 months after operation, which was higher than that of the control group (P < 0.05). The serum ECP, TIgE, IL-6, The TNF-α level showed a decreasing trend, and the serum levels of the above test group decreased greatly. The two groups of serum ECP, TIgE, IL-6, TNF-α levels, different time points and interactions between groups and at different time points The difference was statistically significant (P<0.05). The SF-36 scores increased at 1 month and 3 months after operation, and the SF-36 score increased significantly in the experimental group. SF-36 There were significant differences in the interaction between the score groups, at different time points, and between groups at different time points (P<0.05). Conclusion: Low-dose clarithromycin combined with endoscopic nasal septum correction and sinus open surgery in patients with chronic rhinosinusitis can improve the therapeutic effect, reduce serum ECP and TIgE levels, reduce the body's inflammatory response and improve the quality

关 键 词：慢性鼻-鼻窦炎 克拉霉素 鼻内镜下鼻中隔矫正术 鼻窦开放术 嗜酸性粒细胞阳离子蛋白 总免疫球蛋白E文献标识码A文章编号1006-6233(2019)06-0881-06 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]