不同糖皮质激素对CRSwNP鼻内窥镜手术患者鼻粘膜功能、鼻粘膜重塑及术后出血的影响  

Effects of different glucocorticoids on nasal mucosa function,remodeling of nasal mucosa and postoperative bleeding in patients undergoing CRSwNP nasal endoscopic surgery

作　　者：伏飞达[1] 杨明[1] 王旭[1] 朱晓燕[1] 郭清华 刘玉[1] 贾菊花[2] FU Fei-da;YANG Ming;WANG Xu;ZHU Xiao-yan;GUO Qing-hua;LIU Yu;JIA Ju-hua(Department of Otolaryngology,Nanjing Integrated Traditional Chinese and Western Medicine Hospital,Nanjing 210014;Department of Pharmacy,Jiangsu Province Hospital,Nanjing 210036,Jiangsu,China)

机构地区：[1]南京市中西医结合医院耳鼻喉科,江苏南京210014 [2]江苏省人民医院药学部,江苏南京210036

出　　处：《川北医学院学报》2022年第3期290-293,共4页Journal of North Sichuan Medical College

基　　金：国家自然科学基金面上项目(82071042)。

摘　　要：目的:探讨布地奈德和糠酸莫米松对慢性鼻-鼻窦炎伴鼻息肉(CRSwNP)鼻内窥镜手术患者鼻粘膜功能、鼻粘膜重塑及术后出血的影响。方法:选取80例接受鼻内窥镜治疗的CRSwNP患者为研究对象,按照术后治疗方法不同分为A组和B组,每组各40例。A组采用糠酸莫米松治疗;B组采用布地奈德治疗,疗程均为8周。比两组患者术后疗效,手术前1 d和手术8周后鼻粘液清除速度、鼻粘液纤毛清除率和血管内皮生长因子(VEGF)、粒细胞-巨噬细胞集落剌激因子(GM-CFS)和转化生长因子-β1(TGF-β1)表达水平、术后出血及不良反应发生情况。结果:A组患者总有效率高于B组(P<0.05)。手术后,两组患者鼻粘液纤毛清除率和纤毛清除速度均升高(P<0.05),且A组高于B组(P<0.05);两组患者VEGF、GM-CFS、TGF-β1检测A值均降低(P<0.05),且A组低于B组(P<0.05)。A组患者术后出血率低于B组(P<0.05);两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:在CRSwNP鼻内窥镜手术患者中,布地奈德和糠酸莫米松均具有良好的临床疗效,但糠酸莫米松更有利于促进鼻粘膜修复,抑制术后鼻腔重塑,减少术后出血事件。Objective:To analyze the effects of budesonide and mometasone furoate on nasal mucosa function,remodeling and postoperative bleeding in patients undergoing chronic rhinosinusitis with nasal polyp(CRSwNP)nasal endoscopic surgery.Methods:A total of 80 patients with CRSwNP who received nasal endoscopy were selected as the study subjects.According to different treatment methods,they were divided into group A and group B,with 40 cases in each group.Group A was treated with mometasone furoate,group B was treated with budesonide,the course of treatment was 8 weeks.The postoperative efficacy of the two groups were compared.The clearance rate of nasal mucus,clearance rate of nasal mucus cilia,expression of vascular endothelial growth factor(VEGF),granulocyte-macrophage colony stimulating factor(GM-CFS)/transforming growth factor-β1(TGF-β1),postoperative bleeding and adverse reactions were compared between the two groups 1 d before and 8 weeks after surgery.Results:The total effective rate in group A was higher than that in group B(P<0.05).The ciliary clearance rate and ciliary clearance speed of nasal mucus in two groups were increased after operation,and group A was higher than group B(P<0.05).After surgery,VEGF,GM-CFS and TGF-β1 A values in the two groups were decreased,and group A was lower than group B(P<0.05).The postoperative bleeding rate of group A was lower than that of group B(P<0.05).There was no statistical significance in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Both budesonide and mometasone furoate have good clinical efficacy in patients undergoing CRSwNP nasal endoscopic surgery,but mometasone furoate is more conducive to promoting nasal mucosal repair,inhibiting nasal remodeling and reducing postoperative bleeding events.

关 键 词：CRSwNP 鼻内窥镜 布地奈德 糠酸莫米松 鼻粘膜修复 鼻腔重塑 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]