氨溴索静脉注射联合雾化吸入对呼吸道黏膜上皮纤毛形态与功能的影响  

Effects of ambroxol intravenous injection combined with aerosol inhalation on morphology and function of respiratory mucosa epithelial cilia

作　　者：周锐[1] 李佳[2] 孙杰[1] 白金霞 宋威 卢昕媛 张涛 张黔[1] 万健[1] ZHOU Rui;LI Jia;SUN Jie;BAI Jinxia;SONG Wei;LU Xinyuan;ZHANG Tao;ZHANG Qian;WAN Jian(Department of Emergency and Critical Care Medicine,Pudong New Area People′s Hospital,Shanghai 200000,China;Department of Otolaryngology,Pudong New Area People′s Hospital,Shanghai 200000,China)

机构地区：[1]上海市浦东新区人民医院急诊与重症医学科,200000 [2]上海市浦东新区人民医院耳鼻喉科,200000

出　　处：《重庆医学》2022年第9期1545-1548,1553,共5页Chongqing medicine

基　　金：上海市科学技术委员会生物医药领域产学研医项目(19DZ1910603);上海市医学重点专科建设项目(ZK2019C08)。

摘　　要：目的分析氨溴索静脉注射联合雾化吸入对呼吸道黏膜上皮纤毛形态与功能的影响。方法选取该院2020年1月至2021年5月收治的慢性鼻-鼻窦炎伴鼻息肉(CRSwNP)且行鼻内镜切除术的患者120例,按随机数字表法分为注射组和雾化组,注射组(n=60)术后使用氨溴索注射液静脉注射治疗;雾化组(n=60)术后使用氨溴索注射液静脉注射联合雾化吸入治疗,观察并记录两组临床疗效、治疗前后窦腔黏膜上皮纤毛形态(炎症细胞浸润、病理性腺体增生、纤毛细胞减少、黏膜细胞水肿及黏膜组织增生)、功能[鼻黏膜纤毛清除率(NMCR)、鼻黏膜纤毛清除速度(NMCS)、鼻黏膜纤毛传输速度(NMTS)]及不良反应,然后进行统计学分析。结果雾化组临床总有效率(95.00%)高于注射组(81.67%),差异有统计学意义(P<0.05);两组治疗后炎症细胞浸润、病理性腺体增生、纤毛细胞减少、黏膜细胞水肿及黏膜组织增生均明显减少(P<0.05),雾化组炎症细胞浸润、病理性腺体增生、纤毛细胞减少、黏膜细胞水肿及黏膜组织增生程度明显低于注射组(P<0.05);两组治疗后NMCR、NMCS及NMTS均明显提升,雾化组治疗后NMCR、NMCS及NMTS高于注射组(P<0.05);不良反应总发生率两组间差异无统计学意义(P>0.05)。结论相比于单纯氨溴索静脉注射治疗,氨溴索静脉注射联合雾化吸入对CRSwNP患者呼吸道黏膜上皮纤毛形态与功能的改善效果更显著,临床疗效更高,不良反应无明显增加。Objective To analyze the effects of ambroxol intravenous injection combined with aerosol inhalation on the morphology and function of respiratory mucosa epithelial cilia.Methods A total of 120 patients with chronic rhinosinusitis complicating nasal polyp(CRSwNP)treated by endoscopic resection in this hospital from January 2020 to May 2021 were selected and divided into the injection group and treatment group according to the random number table method.The injection group(n=60)treated by postoperative ambroxol intravenous injection intravenous;the atomization group(n=60)treated by ambroxol intravenous injection combined with atomization inhalation after surgery.The clinical curative effect,sinus cavity mucosal epithelial cilia morphology before and after treatment(inflammatory cells infiltration,hyperplasia of pathologic glands,ciliated cells reduce,edema of mucosa cells and mucous membrane tissue hyperplasia),function[nasal mucosa cilia clearance rate(NMCR)and nasal mucosa cilia clearance speed(NMCS)and nasal mucosa cilia transmission speed(NMTS)]and adverse reactions were observed and recorded.Then the statistical analysis was performed.Results The total clinical effective rate of the atomization group was higher than that of injection group,and the difference was statistically significant(95.00%vs.81.67%,P<0.05).The inflammatory cells infiltration,pathologic glands hyperplasia,ciliated cell reduce,edema of mucosa cells and mucous membrane tissue hyperplasia after treatment in the two groups were significantly reduced(P<0.05);the degrees of inflammatory cells infiltration,hyperplasia of pathologic glands,ciliated cells reduce,edema of mucosa cells and mucous membrane tissue hyperplasia in the atomization group were significantly lower than those in the injection group(P<0.05);NMCR,NMCS and NMTS after treatment in the two groups were significantly increased,and the values of NMCR,NMCS and NMTS indexes after treatment in the atomization group were higher than those in the injection group(P<0.05).There was no diffe

关 键 词：慢性鼻-鼻窦炎伴鼻息肉 氨溴索 雾化 纤毛形态 纤毛功能 

分 类 号：R969[医药卫生—药理学]