慢性鼻窦炎鼻息肉合并支气管哮喘患者鼻窦内镜术后对支气管哮喘疗效的影响  

Effect of endoscopic sinus surgery on asthmatic patients with chronic sinusitis and nasal polyps

作　　者：洪苏玲[1] 黄江菊[1] 杨玉成[1] 康厚墉[1] 王祎琴[1] 孙荣[1] 钱迪[1] 董小琴[1] 

机构地区：[1]重庆医科大学附属第一医院耳鼻咽喉科,400016

出　　处：《中华耳鼻咽喉科杂志》2004年第3期139-142,共4页Chinese Journal of Otorhinolaryngology

摘　　要：目的　观察鼻窦内镜术 (endoscopicsinussurgery ,ESS)对慢性鼻窦炎伴支气管哮喘患者哮喘发作的影响。方法　对 2 10例慢性鼻窦炎患者施行ESS术 ,其中伴有支气管哮喘病史者 4 2例(2 0 0 % )。 2 10例患者均于术前、术后采用酶联免疫吸附测定法 (ELISA)检测外周血单个核细胞(PBMC)培养上清液中的白细胞介素 4 (IL 4 ) ,干扰素γ(IFN γ) ,可溶性白细胞介素 2受体 (sIL 2R)和可溶性IgE低亲和力受体 (solubeCD2 3 ,sCD2 3 )的含量 ,并与 2 0例正常对照组进行比较。通过主观和客观标准评定 4 2例患者哮喘发作及对皮质类固醇的耐受状况 ,并对术后患者进行为期 1年 (10例 )和 3年(32例 )的随访。结果　鼻窦炎合并支气管哮喘患者术前PBMC培养上清液中IL 4 ,sIL 2R、sCD2 3 含量较对照组显著升高 ,而IFN γ含量较对照组显著减少。术后IL 4、sIL 2R、sCD2 3 含量较对照组显著降低 ,而IFN γ含量显著增高。术后哮喘改善水平由随访术后 1年的 4 5 %提高到术后 3年的 70 %。 4 2例中 32例 (76 % )哮喘发作次数明显减少 ,术前长期服用类固醇的 2 1例中 ,14例 (6 7% )减少了对口服类固醇的使用。结论　ESS对慢性鼻窦炎伴支气管哮喘患者的治疗有较满意的远期疗效。ESS能调节IL 4、IFN γ、sIL 2R、sCD2 3 水平 。Objectives To explore the effect of endoscopic sinus surgery (ESS) in patients with chronic rhinosinusitis and asthma Methods Forty two patients with asthma who underwent ESS and control group were investigated Interleukin 4 (IL 4), interferon γ (IFN γ), soluble interleukin 2 receptor (sIL 2R) and soluble CD 23 (sCD 23 )levels in culture supernatant of peripheral blood mononuclear cell (PBMC) were determined by enzyme linked immunosorbent assay (ELISA) Results Of these 42 patients 32 (76%), their asthma was relieved greatly after ESS comparing with that before ESS 14 of 21 patients (67%) taken regular medication for asthma before ESS reported that less medicine was used after operation Conclusion This study demonstrates that ESS has a favorable effect on asthma in patients with symptomatic chronic sinusitis.

关 键 词：慢性鼻窦炎 鼻息肉 合并症 支气管哮喘 鼻窦内镜术 检测 

分 类 号：R765[医药卫生—耳鼻咽喉科]