低剂量克拉霉素在慢性鼻-鼻窦炎鼻内镜术中的应用及对患者血清ECP、TIgE水平影响  

Application of low-dose clarithromycin in nasal endoscopy and its influence on serum ECP and TIgE levels in patients with chronic rhinosinusitis

作　　者：周凯 王延辉 秦晓雯 吴媛[1] 袁杰 杨帆[1] ZHOU Kai;WANG Yanhui;QIN Xiaowen(Department of Otorhinolaryngology,the Affiliated Hospital of Northwest University(Xi’an No.3 Hospital),Xi’an 710018)

机构地区：[1]西北大学附属医院(西安市第三医院)耳鼻喉科,西安710018

出　　处：《陕西医学杂志》2020年第8期1025-1028,共4页Shaanxi Medical Journal

基　　金：陕西省卫生科研基金资助项目(2018H03)。

摘　　要：目的:探讨低剂量克拉霉素在慢性鼻-鼻窦炎患者鼻内镜术中的应用及对患者血清嗜酸细胞阳离子蛋白(ECP)、血清总免疫球蛋白E(TIgE)水平的影响。方法:选取90例行鼻内镜术的慢性鼻-鼻窦炎患者作为研究对象,随机数表法分为观察组和对照组各45例,对照组给予鼻内镜术联合常规抗菌治疗,观察组在对照组基础上联合低剂量克拉霉素治疗。观察两组患者治疗有效率,治疗前后鼻内镜评分(Lund-Kennedy)变化,血清ECP、TIgE和炎性因子的变化,术后3个月不良反应发生率。结果:观察组治疗有效率为93.33%高于对照组的77.78%,两组比较差异有统计学意义(P<0.05);两组患者治疗后1周、1个月、3个月的Lund-Kennedy评分低于治疗前;治疗后1周、1个月、3个月,观察组Lund-Kennedy评分均低于对照组,差异有统计学意义(P<0.05);治疗后,观察组血清ECP、TIgE、白细胞介素(IL)-6、IL-1β、IL-8、肿瘤坏死因子-α(TNF-α)水平均低于对照组,差异有统计学意义(P<0.05);两组不良反应率比较无统计学差异(P>0.05)。结论:低剂量克拉霉素可提高慢性鼻-鼻窦炎患者鼻内镜术后的治疗有效率,降低患者Lund-Kennedy评分、血清炎性因子和ECP、TIgE水平。Objective:To explore the application of low-dose clarithromycin in nasal endoscopy and its influence on serum eosinophil cationic protein(ECP)and total immunoglobulin E(TIgE)in patients with chronic rhinosinusitis.Methods:Ninety patients with chronic rhinosinusitis who underwent nasal endoscopy were selected as the research objects and divided into observation group and control group according to random number table method,with 45 cases in each group.The control group was treated with nasal endoscopy combined with routine antibacterial therapy,while the observation group was treated with low-dose clarithromycin on the basis of the control group.The effective rate of treatment,the change of nasal endoscopy score(Lund-Kennedy),the changes of serum ECP,TIgE and inflammatory factors before and after treatment,and the incidence of adverse reactions at 3 months after surgery in both groups were observed.Results:The effective rate of treatment in the observation group was higher than that in the control group(93.33%vs.77.78%)(P<0.05).At 1 week,1 month and 3 months after treatment,Lund-Kennedy scores in both groups were lower than those before treatment,and which were lower in observation group compared with control group(P<0.05).After treatment,the levels of serum ECP,TIgE,interleukin(IL)-6,IL-1β,IL-8 and tumor necrosis factor-α(TNF-α)in the observation group were lower than those in the control group(P<0.05).There was no significant difference in incidence of adverse reactions between the two groups(P>0.05).Conclusion:Low-dose clarithromycin can improve effective rate of treatment in patients with chronic rhinosinusitis after nasal endoscopy,reduce Lund-Kennedy score and the levels of serum inflammatory factors,ECP and TIgE.

关 键 词：慢性鼻-鼻窦炎 治疗 克拉霉素 鼻内镜检查 嗜酸细胞阳离子蛋白 血清总免疫球蛋白E 

分 类 号：R765.4[医药卫生—耳鼻咽喉科]