鼻内镜手术联合糠酸莫米松鼻喷雾剂治疗慢性鼻窦炎伴鼻息肉疗效及对患者鼻黏膜CD4^(+)及CD8^(+)T细胞分布的影响被引量：6

Efficacy of nasal endoscopic surgery combined with Mometasone furoate nasal spray in the treatment of chronic sinusitis with nasal polyps and its effect on the distribution of CD4^(+)and CD8^(+)T cells in nasal mucosa

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摘要目的:探讨鼻内镜手术(FESS)联合糠酸莫米松鼻喷雾剂治疗慢性鼻窦炎伴鼻息肉(CRSwNP)的疗效及对鼻黏膜CD4^(+)及CD8^(+)T细胞分布的影响。方法:选择96例CRSwNP患者,按随机数字表法分为对照组(FESS)和观察组(FESS联合糠酸莫米松鼻喷雾剂)各48例。比较两组临床疗效,治疗前后鼻腔通气功能、鼻黏膜CD4^(+)及CD8^(+)T细胞分布、鼻黏液纤毛清除功能及复发率。结果:对照组无效10例,总有效率79.17%,观察组无效2例,总有效率95.83%,两组比较差异有统计学意义(均P<0.05)。观察组治疗后血清肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)水平下降,低于对照组,鼻黏膜功能均优于对照组,CD4^(+),CD4^(+)/CD8^(+)较对照组升高,CD8^(+)较对照组下降(均P<0.05)。且观察组患者术后1年内的复发率为4.17%,明显低于对照组的22.92%(χ^(2)=7.207,P<0.05)。结论:鼻内镜手术联合糠酸莫米松鼻喷剂治疗慢性鼻窦炎伴鼻息肉效果较好,且复发率低,能够降低患者的炎性反应,促进黏膜免疫功能修复,提高黏液纤毛清除功能。 Objective:To investigate the efficacy of endoscopic nasal surgery(FESS)combined with Mometasone furoate nasal spray in the treatment of chronic sinusitis with nasal polyps(CRSwNP)and the effect on the distribution of CD4^(+)and CD8^(+)T cells in nasal mucosa.Methods:A total of 96 patients with CRSwNP were divided into control group(FESS)and observation group(FESS combined with Mometasone furoate nasal spray)according to random number table method,48 cases in each group.The clinical efficacy,nasal ventilation function,CD4^(+)and CD8^(+)T cell distribution,nasal mucociliary clearance function and recurrence rate were compared before and after treatment.Results:TThere were 10 ineffective cases in the control group,the total effective rate was 79.17%,and 2 ineffective cases in the observation group,the total effective rate was 95.83%(all P<0.05).After treatment,the levels of serum TNF-α,hs-CRP and IL-6 in the observation group were lower than those in the control group,and the functions of nasal mucosa were better than those in the control group,CD4^(+),CD4^(+)/CD8^(+)were higher than those in the control group,and CD8^(+)were lower than those in the control group(P<0.05).The recurrence rate of observation group was 4.17%(2/48),which was significantly lower than that of control group 22.92%(11/48)(χ^(2)=7.207,all P<0.05).Conclusion:Nasal endoscopic surgery combined with mometasone furoate nasal spray for the treatment of chronic sinusitis with nasal polyps is effective and has a low recurrence rate,which can reduce the inflammatory response of patients,promote the repair of mucosal immune function and improve the mucous ciliary clearance function,and is worthy of clinical promotion.

作者宋鹏徐杨斌 SONG Peng;XU Yangbin(Department of Otolaryngology-Head and Neck Surgery,Ningde Hospital,Ningde Normal University,Ningde 352100,China)

机构地区宁德师范学院附属宁德市医院耳鼻咽喉头颈外科

出处《陕西医学杂志》 CAS 2025年第1期105-108,113,共5页 Shaanxi Medical Journal

基金福建省自然科学基金资助项目(2021J011167)。

关键词鼻内镜手术细胞免疫功能慢性鼻窦炎伴鼻息肉糠酸莫米松鼻喷雾剂复发率炎性因子 Nasal endoscopic surgery Cellular immune function Chronic sinusitis with nasal polyps Mometasone furoate nasal spray Recurrence rate Inflammatory factors

分类号 R765.1 [医药卫生—耳鼻咽喉科]

作者简介通讯作者:徐杨斌,E-mail:314853079@qq.com。