局部糖皮质激素治疗对儿童腺样体肥大合并过敏性鼻炎的疗效影响  

Effect of local glucocorticoid therapy on adenoid hypertrophy complicated with allergic rhinitis in children

作　　者：胡燕萍[1] 周珍[2] 倪海峰[2] 宋洋[3] Hu Yanping;Zhou Zhen;Ni Haifeng;Song Yang(Department of Otolaryngology,Hangzhou Cancer Hospital,Zhejiang 310022,China;Department of Otolaryngology,Hangzhou First Municipal Hospital,Zhejiang 310022,China;Department of Surgical Oncology,Hangzhou Cancer Hospital,Zhejiang 310022,China)

机构地区：[1]杭州市肿瘤医院耳鼻喉科,310022 [2]杭州市第一人民医院耳鼻喉科,310022 [3]杭州市肿瘤医院肿瘤外科,310022

出　　处：《中国药物与临床》2022年第7期586-589,共4页Chinese Remedies & Clinics

基　　金：浙江省医药卫生科技计划项目(2021KY870)。

摘　　要：目的 探究局部糖皮质激素治疗儿童腺样体肥大合并过敏性鼻炎的临床疗效。方法 选择2018年1月至2020年12月在杭州市肿瘤医院和杭州市第一人民医院就诊的儿童腺样体肥大患者为研究对象,共149例,通过过敏性鼻炎评分问卷(SFAR)了解患者过敏性鼻炎的病情并且依据临床和实验室检查结果进行分组。A组为非过敏性鼻炎患者,B组为合并过敏性鼻炎患者。患者接受鼻内局部糠酸莫米松(100μg/d)治疗至少3个月。鼻塞和打鼾的严重程度通过视觉模拟评分(VAS)进行评价,比较治疗前后的腺体厚度与鼻咽部最大空间前后径比值(A/N比率)以及转诊至手术治疗的概率。结果 治疗前后组内比较A/N比率差异有统计学意义(P<0.01)。治疗后A组(0.61±0.11)与B组(0.65±0.14)相比,A/N比率差异有统计学意义(P=0.021)。组内比较治疗前后VAS评分差异有统计学意义(P<0.01),同时A组的手术转诊率低于B组(35%和56%,P=0.028)。结论 局部糖皮质激素治疗能够显著改善腺样体肥大儿童患者的A/N比率和症状评分,存在过敏性鼻炎时临床疗效相对较差,并且转至外科手术治疗的概率较高。Objective To investigate the impacts of allergic rhinitis on the clinical efficacy of steroids therapy in children with adenoid hypertrophy.Methods Included were 149 children with adenoid hypertrophy treated in Hangzhou Cancer Hospital and Hangzhou First Municipal Hospital between January 2018 and December 2020.The patients were assessed for severity of allergic rhinitis by using Score for Allergic Rhinitis Questionnaire(SFAR),and according to clinical and laboratory findings,were assigned to group A(with noallergic rhinitis) and group B(with allergic rhinitis).All patients received intranasal spray of mometasone furoate(100 μg/ml)for at least 3 months.The severity of nasal obstruction and snoring was assessed by visual analogue scale(VAS).The ratio of adenoidaldepths to the maximum diameter of nasopharynx(A/N ratio) before and after treatment,as well as the rate of referral to surgery,were compared between groups.Results There was a statistically significant within-group difference in the A/N ratio before and after the treatment(P<0.01).After treatment,group A experienced greater reduction compared with group B,with A/N ratios being(0.61±0.11) and(0.65±0.14),respectively(P=0.021).There was a statistically significant within-group difference in VAS score before and after treatment(P<0.01).The rate of referral to surgery was lower in group A was than that in group B(35% vs 56%,P=0.028).Conclusion Topical steroids therapy can significantly improve the A/N ratio and symptom score in children with adenoid hypertrophy,however,presence of allergic rhinitis results in poorer clinical efficacy and higer referral rate to surgery.

关 键 词：鼻炎 过敏性 儿童 糖皮质激素类 

分 类 号：R766[医药卫生—耳鼻咽喉科] R765.21[医药卫生—临床医学]