鼻内窥镜微创手术治疗鼻窦炎的疗效及对血清ECP HMGB1 IL-1βIL-21水平的影响  

Curative Effect of Minimally Invasive Nasal Endoscopic Surgery on Sinusitis and Its Influences on Serum ECP HMGB1 IL-1βand IL-21 Levels

作　　者：王明香 张绍芳[1] 陈薇 黄凌锋 WANG Mingxiang;ZHANG Shaofang;CHEN Wei(Chenzhou First People's Hospital,Hunan Chenzhou 423000,China)

机构地区：[1]湖南省郴州市第一人民医院耳鼻喉科,湖南郴州423000

出　　处：《河北医学》2021年第9期1548-1553,共6页Hebei Medicine

基　　金：湖南省卫生健康委科研课题,(编号:hnwsjkjg2020019)。

摘　　要：目的:探究鼻内窥镜微创手术治疗鼻窦炎的疗效及对血清中嗜酸性粒细胞阳离子蛋白(eosinophile cationic protein,ECP)、高迁移率族蛋白-1(high mobility group protein B1,HMGB1)、白细胞介素-1β(interleukin-1β,IL-1β)、白细胞介素-21(interleukin-21,IL-21)的影响。方法:选择2019年1月至2020年10月来我院就诊的鼻窦炎患者163例,按照随机数表法分成观察组(n=81)和对照组(n=82),对照组采用微波热凝手术治疗,观察组采用鼻内窥镜微创手术治疗,两组均随访3个月,比较两组治疗3个月后的临床疗效,治疗前后采用视觉模拟量表(visual analogue scale,VAS)评估患者鼻窦炎主观症状,采用Lund-Kennedy内镜评分评估鼻内镜下各黏膜形态,采用鼻腔鼻窦结局测试-20评分(sinonasal outcometest-20,SNOT-20)评估患者生活质量,并比较两组治疗前后的ECP、HMGB1、IL-1β、IL-21水平。结果:治疗后,观察组患者的总有效率为92.59%,高于对照组的81.71%(P<0.05);治疗后,观察组均流涕、鼻塞、面颊部疼痛、头痛、嗅觉减退的VAS评分为(2.03±0.52)分、(2.15±0.58)分、(1.24±0.37)分、(0.96±0.32)分、(1.25±0.31)分均低于对照组的(3.45±0.84)分、(3.21±0.74)分、(2.08±0.56)分、(1.36±0.41)分、(2.62±0.48)分(P<0.05);治疗后,观察组Lund-Kennedy评分、SNOT-20评分分别为(1.51±0.42)分、(2.08±0.62)分,均低于对照组的(2.52±0.67)分、(3.61±0.86)分(P<0.05);治疗后,观察组的ECP、HMGB1、IL-1β、IL-21水平分别为(4.23±1.08)ng/L、(64.25±6.13)μg/L、(30.25±4.36)pg/mL、(72.16±12.34)pg/mL,均低于对照组的(5.46±1.31)ng/L、(72.18±7.29)μg/L、(38.47±5.19)pg/mL、(86.25±14.17)pg/mL(P<0.05)。结论:鼻内窥镜微创手术治疗鼻窦炎疗效好,能够有效改善患者的临床症状,降低患者的变态反应及炎性水平,提高患者的生活质量。Objective:To explore the curative effect of minimally invasive nasal endoscopic surgery on sinusitis and its influences on levels of serum eosinophile cationic protein(ECP),high mobility group protein B1(HMGB1),interleukin-1β(IL-1β)and interleukin-21(IL-21).Methods:A total of 163 sinusitis patients treated in the hospital from January 2019 to October 2020 were enrolled and divided into observation group(81 cases)and control group(82 cases)by random number table method.The control group was treated with microwave thermo-coagulation,while observation group was treated with minimally invasive nasal endoscopic surgery.Both groups were followed up for 3 months.The clinical curative effect after 3 months of treatment between the two groups was compared.Before and after treatment,subjective symptoms of sinusitis were evaluated by visual analogue scale(VAS).The morphology of nasal mucosa was evaluated by Lund-Kennedy endoscope scoring method.And their quality of life was assessed by sinonasal outcometest-20(SNOT-20).The levels of ECP,HMGB1,IL-1βand IL-21 before and after treatment between the two groups were compared.Results:After treatment,the total response rate was higher in observation group than control group(92.59%vs 81.71%)(P<0.05).After treatment,scores of VAS(runny nose,nasal congestion,cheek pain,headache,hyposmia)in observation group were(2.03±0.52)points,(2.15±0.58)points,(1.24±0.37)points,(0.96±0.32)points and(1.25±0.31)points,lower than those in control group[(3.45±0.84)points,(3.21±0.74)points,(2.08±0.56)points,(1.36±0.41)points,(2.62±0.48)points](P<0.05).After treatment,scores of Lund-Kennedy and SNOT-20 in observation group were(1.51±0.42)points and(2.08±0.62)points,lower than those in control group[(2.52±0.67)points,(3.61±0.86)points](P<0.05).After treatment,levels of ECP,HMGB1,IL-1βand IL-21 in observation group were(4.23±1.08)ng/L,(64.25±6.13)μg/L,(30.25±4.36)pg/mL and(72.16±12.34)pg/mL,lower than those in control group[(5.46±1.31)ng/L,(72.18±7.29)μg/L,(38.47±5.19)pg/mL,(86.

关 键 词：鼻窦炎 鼻内窥镜微创手术 嗜酸性粒细胞阳离子蛋白 高迁移率族蛋白-1 白细胞介素-1β 白细胞介素-21 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]