[1]宋 鹏,徐杨斌.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[J].陕西医学杂志,2025,54(1):105-108,113.[doi:DOI:10.3969/j.issn.1000-7377.2025.01.021]
　SONG Peng,XU Yangbin.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[J].,2025,54(1):105-108,113.[doi:DOI:10.3969/j.issn.1000-7377.2025.01.021]
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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
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
54
期数:
2025年1期
页码:
105-108,113
栏目:
药物与临床
出版日期:
2025-01-05

文章信息/Info

Title:
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
作者:
宋 鹏; 徐杨斌
(宁德师范学院附属宁德市医院耳鼻咽喉头颈外科,福建 宁德 352100)
Author(s):
SONG Peng; XU Yangbin
(Department of Otolaryngology-Head and Neck Surgery,Ningde Hospital,Ningde Normal University,Ningde 352100,China)
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
Keywords:
Nasal endoscopic surgery;  Cellular immune function;  Chronic sinusitis with nasal polyps;  Mometasone furoate nasal spray;  Recurrence rate;  Inflammatory factors
分类号:
R 765.1
DOI:
DOI:10.3969/j.issn.1000-7377.2025.01.021
文献标志码:
A
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%(χ2=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。
Abstract:
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)(χ2=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.

参考文献/References:

[1] 陈影影,杨花荣,吴云姣.慢性鼻窦炎伴鼻息肉的临床治疗进展[J].医学理论与实践,2023,36(1):37-39.
[2] 杨花荣,陈影影,高英,等.慢性鼻-鼻窦炎伴鼻息肉鼻内镜术后复发调查及危险因素分析[J].陕西医学杂志,2023,52(2):184-187.
[3] 周何.双歧杆菌三联活菌辅助美沙拉嗪对溃疡性结肠炎患者疾病活动指数及炎性因子水平的影响[J].系统医学,2022,7(5):22-25.
[4] 谈齐峰,贾金文,雍军,等.嗜酸性粒细胞、调节性T细胞对慢性鼻窦炎伴鼻息肉的诊断及预后预测价值分析[J].现代生物医学进展,2023,23(19):3630-3635.
[5] 曹倩,胡伟玲,高敏,等.379例炎症性肠病临床特征分析[J].中华消化杂志,2005,25(4):222-225.
[6] 崔君柯.布地奈德混悬液联合特布他林治疗慢阻肺急性加重期的效果[J].实用中西医结合临床,2019,19(3):68-69.
[7] 盛云如,吴雪,朱足玲.鼻内镜手术联合糖皮质激素治疗慢性鼻窦炎伴鼻息肉的临床有效性及安全性探讨[J].大医生,2023,8(8):58-60.
[8] 朱谦,马婕,石崧.鼻内镜手术联合糖皮质激素浸润对慢性鼻窦炎伴鼻息肉患者远期疗效及鼻功能的影响[J].贵州医药,2023,47(2):213-214.
[9] 敖天,程雷.慢性鼻窦炎伴鼻息肉的内型研究及其指导下的精准控制与治疗[J].山东大学耳鼻喉眼学报,2022,36(3):7-14.
[10] SHEN S,XIAN M,YAN B,et al.Anti-thymic stromal lymphopoietin monoclonal antibody in patients with chronic rhinosinusitis with nasal polyps(DUBHE):Rationale and design of a multicenter,randomized,double-blind,placebo-controlled study[J].Asia Pac Allergy,2024,14(1):26-31.
[11] 李建玲,章松林,刘杰.鼻内镜手术结合鼻腔冲洗液治疗慢性鼻窦炎疗效研究[J].陕西医学杂志,2018,47(11):1457-1459.
[12] MARTIN-JIMENEZ D,MORENO-LUNA R,CALLEJON-LEBLIC A,et al.Long-Term clinical outcomes in patients with chronic rhinosinusitis with nasal polyps associated with expanded types of endoscopic sinus surgery[J].J Clin Med,2024,13(3):866.
[13] SHAGHAYEGH G,COOKSLEY C,BOURAS G,et al.Staphylococcus aureus biofilm properties and chronic rhinosinusitis severity scores correlate positively with total CD4+T-cell frequencies and inversely with its Th1,Th17 and regulatory cell frequencies[J].Immunology,2023,170(1):120-133.
[14] MASPERO J F,ANSELMO-LIMA W,BEDOYA D,et al.Management of CRSwNP in latin america:A multidisciplinary consensus from an expert working group[J].World Allergy Organ J,2024,17(3):100886.
[15] 钱燕妮,李海洋,刘勇,等.预防性应用鼻腔冲洗及糠酸莫米松鼻喷剂对变应性鼻炎疗效的影响[J].重庆医学,2023,52(21):3259-3263.
[16] 白芸芸,佘秀梅,乔彦明.鼻内窥镜联合糠酸莫米松治疗慢性鼻-鼻窦炎伴鼻息肉的疗效及其对患者远期预后的影响[J].海南医学,2022,33(7):875-878.
[17] 巫荣辉,钟晶.糠酸莫米松喷鼻剂联合鼻内镜手术对治疗慢性鼻窦炎患者的意义[J].上海医药,2023,44(8):27-30.
[18] 张海慧.糠酸莫米松鼻喷雾剂对小儿变应性鼻炎治疗效果及炎症因子水平的影响[J].中外女性健康研究,2023(14):86-87.
[19] 王伟,赵姗姗,张明,等.活性调节蛋白、高迁移率族蛋白1在真菌感染性鼻-鼻窦炎患者中表达水平及与T淋巴细胞亚群相关性[J].临床军医杂志,2023,51(6):649-651.
[20] 李群真,李军,郭树繁,等.辛芷通窍颗粒对慢性鼻窦炎小鼠鼻窦黏膜的保护机制研究[J].陕西中医,2024,45(3):318-322.
[21] 赵康,汪梅花,刘涛.慢性鼻-鼻窦炎伴或不伴鼻息肉患者细胞免疫功能比较及规范化鼻内镜手术临床疗效分析[J].北京医学,2020,42(10):1015-1017.
[22] 黄洁,叶聪,潘灵芝.伊曲康唑联合丹翘酊治疗马拉色菌性毛囊炎的疗效观察[J].实用中西医结合临床,2019,19(10):148-149.
[23] 郭永进.慢性鼻窦炎鼻息肉经功能性鼻内镜术后鼻腔冲洗联合糠酸莫米松喷雾剂治疗疗效观察[J].中国药物与临床,2020,20(12):2018-2020.
[24] 刘骥,林云,邹映东,等.慢性鼻-鼻窦炎患者细胞免疫功能与规范化鼻内镜手术疗效分析[J].中国眼耳鼻喉科杂志,2019,19(2):9492-9499.
[25] 徐翔,葛亮,刘蓓,等.鼻内镜术后鱼腥草滴鼻液与糠酸莫米松鼻喷雾剂联合局部应用对鼻黏膜组织重塑的影响研究[J].中国耳鼻咽喉头颈外科,2020,27(1):43-46.

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备注/Memo

备注/Memo:
基金项目:福建省自然科学基金资助项目(2021J011167)
更新日期/Last Update: 2025-01-06