布地奈德联合克拉霉素对行鼻窦内窥镜手术的慢性鼻窦炎患者血清HMGB1及HCGP-39表达的影响  

Impacts of budesonide combined with clarithromycin on the expressions of serum HMGB1 and HCGP-39 in patients with chronic sinusitis undergoing endoscopic sinus surgery

作　　者：章程[1] ZHANG Cheng(Department of ENT,Hunan Aerospace Hospital,Hunan,Changsha 410205,China)

机构地区：[1]湖南航天医院耳鼻喉科,湖南长沙410205

出　　处：《中国医药科学》2022年第18期165-169,共5页China Medicine And Pharmacy

摘　　要：目的探讨及研究布地奈德联合克拉霉素对行鼻窦内窥镜手术治疗慢性鼻窦炎患者血清高迁移率族蛋白-1(HMGB1)、白介素-6(IL-6)、白介素-8(IL-8)及人类软骨糖蛋白-39(HCGP-39)的影响。方法选取2017年1月至2020年12月湖南航天医院收治的150例慢性鼻窦炎患者,按照随机数表法分为对照组、克拉霉素组、联合用药组,每组各50例。对照组接受鼻窦内窥镜手术治疗,克拉霉素组在手术基础上联合克拉霉素,联合用药组采取手术+克拉霉素+布地奈德联合治疗,观察三组患者临床疗效、气道重塑情况评分及血清HMGB1及HCGP-39、IL-6、IL-8水平变化情况,采用视觉模拟疼痛量表评估患者疼痛程度。结果术后3个月,联合用药组总有效率为96.00%,高于克拉霉素组的80.00%和对照组的66.00%(P<0.05);治疗后联合用药组鼻窦断层扫描与鼻内镜形态评分均低于对照组、克拉霉素组(P<0.05);联合用药组IL-6、IL-8、HMGB1、HCGP-39水平低于对照组、克拉霉素组(P<0.05);联合用药组疼痛评分低于对照组、克拉霉素组(P<0.05)。结论慢性鼻窦炎患者在鼻窦内窥镜手术治疗基础上联合采用克拉霉素及布地奈德临床疗效良好,能有效改善其炎症反应,降低血清HMGB1及HCGP-39水平,缓解临床症状。Objective To investigate and study the effect of budesonide combined with clarithromycin on serum highmobility group protein B1(HMGB1),interleukin-6(IL-6)and interleukin-8(IL-8)in patients with chronic rhinosinusitis treated by endoscopic sinus surgery and the effect of human cartilage glycoprotein 39(HCGP-39).Methods A total of 150 patients with chronic rhinosinusitis admitted to Hunan Aerospace Hospital from January 2017 to December 2020 were selected and randomly divided into control group,clarithromycin group,and combination group,50 cases in each group.Control group received endoscopic sinus surgery,and clarithromycin group was given clarithromycin on top of surgery,as while combination group treated with surgery+clarithromycin+budesonide combined therapy.The curative effect,airway remodeling score and the changes of serum HMGB1,HCGP-39,IL-6,IL-8 levels in the three groups.The degree of pain was assessed by visual analogue score.Results 3 months after operation,the total effective rate of the combined drug group was 96.00%higher than that of the clarithromycin group(80.00%)and the control group(66.00%)(P<0.05).After treatment,the nasal sinus CT scan and nasal endoscopic morphology scores in the combined drug group were lower than those in the control group and the clarithromycin group(P<0.05).After treatment,the levels of IL-6,IL-8,HMGB1 and HCGP-39 in the combined drug group were lower than those in the control group and the clarithromycin group(P<0.05).The pain score of the group was lower than that of the control group and the clarithromycin group(P<0.05).Conclusion The combination of clarithromycin and budesonide in patients with chronic sinusitis on the basis of endoscopic sinus surgery has a good clinical effect,which can effectively improve their inflammatory response,reduce serum HMGB1 and HCGP-39 levels,a nd relieve clinical symptoms.

关 键 词：布地奈德 克拉霉素 慢性鼻窦炎 高迁移率族蛋白-1 人类软骨糖蛋白-39 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]