非变应性鼻炎不同表型的炎症状况和鼻用糖皮质激素疗效分析  

Inflammation characteristics and treatment effects by intranasal steroid in different types of nonallergic rhinitis

作　　者：王志颐 季寒[1] 施涛 张勇[1] 陈伟[1] 程友[1] 许莉[1] WANG Zhi-yi;JI Han;SHI Tao;ZHANG Yong;CHEN Wei;CHENG You;XU Li(Department of Otolaryngology,General Hospital of Eastern Theater Command,PLA,Nanjing 210002,Jiangsu,China)

机构地区：[1]东部战区总医院(原南京军区南京总医院)耳鼻咽喉头颈外科,南京210002

出　　处：《医学研究生学报》2022年第4期367-370,共4页Journal of Medical Postgraduates

基　　金：中国博士后基金(2018M643842);江苏省博士后基金(2019K085)。

摘　　要：目的 糖皮质激素对不同表型非变应性鼻炎(AR)的影响尚不清楚。方法 收集2020年10月至2021年3月东部战区总医院耳鼻咽喉科就诊的37例NAR伴EOS增多(NARES)患者(NARES组)及58例NAR不伴EOS增高患者(NAR组)。通过病史采集、皮肤点刺实验(SPT)、鼻部症状视觉模拟量化(VAS)评分、血常规、鼻灌洗、诱导痰检查等方式评价分析炎症状况,并对两组同时给予鼻用糖皮质激素治疗观察其疗效。结果 NARES组中鼻灌洗EOS计数[6(3.3~12.6)]、诱导痰EOS比例[2(1~3)]、血Eos比例[(4.54±3.10)%]显著高于NAR组[0.45(0~1.4)、0.5(0.13~1)%、(2.51±1.75)%],差异有统计学意义(P<0.01)。两组患者使用鼻用糖皮质激素治疗8周后,NARES组鼻灌洗EOS计数、诱导痰EOS比例、鼻部症状VAS评分较治疗前明显降低(P<0.05)。结论 NARES患者鼻腔、下气道和全身均出现EOS炎症表现,鼻用糖皮质激素可以有效治疗NARES患者EOS炎症,鼻腔症状有了显著的改善,而对于非NARES患者症状并无明显改善,将NAR按照是否存在EOS浸润分型可能更具有实际意义。Objective Nonallergic rhinitis was classified by the level of EOS. The paperis aimedtodescribe Inflammation characteristics and treatment effects by intranasal steroid in different types of nonallergic rhinitis. Methods We assessed characteristics using skin prick test(SPT), VAS score for nasal symptoms, blood routine examination, nasal douche and induced sputum respectively, in 37 NARES patients(Group NARES), 58 NAR without eosinophilia patients(Group NAR). Both groups were treated with intranasal steroid to observe the treatment effects. Results The eosinophil in nasal douche, induced sputum and serum were all higher in Group NARES than Group NAR(P<0.05),There was significant difference between(P<0.01). After 8 weeks treatment of intranasal steroid, the eosinophil in nasal douche, induced sputum and the VAS score for nasal symptoms in group were all lower than those before treatment(P<0.05). Conclusion EOS inflammation was present in the nasal cavity, lower airway and wholebody in the NARES group. EOS inflammation was effectively treated by intranasal steroid in the NARES group, resulting in significantly improvement in nasal symptoms, but not in the non-NARES group. So nonallergic rhinitis classified by the level of EOS may have more practical significance.

关 键 词：非变应性鼻炎 非变应性鼻炎伴嗜酸性粒细胞增多 鼻灌洗 诱导痰 鼻用糖皮质激素 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]