摘要
目的观察鼻窦炎伴鼻息肉患者经鼻内镜手术后,应用布地奈德喷雾剂的疗效及对鼻窦黏膜嗜酸性粒细胞、基质金属蛋白酶9(MMP-9)表达的影响。方法接受鼻内镜手术治疗的150例鼻窦炎伴鼻息肉患者,随机均分为观察组和对照组各75例。观察组术后应用布地奈德3个月;对照组术后不应用布地奈德。观察两组疗效,术前、术后1个月及3个月内镜黏膜形态评分系统得分;术中、术后1个月、3个月时采集鼻窦黏膜组织,检测嗜酸性粒细胞个数、MMP-9表达水平。结果观察组临床疗效明显优于对照组,差异有统计学意义(P<0.05)。两组Lund-Kenndey评分、嗜酸性粒细胞计数均呈持续下降趋势(P_(时点)<0.05);观察组Lund-Kenndey评分、嗜酸性粒细胞计数明显低于对照组,差异有统计学意义(P_(组别)<0.05);时间效应与分组效应存在明显的交互作用(P_(交互)<0.05)。两组鼻窦黏膜组织MMP-9表达水平均呈持续上升趋势(P_(时点)<0.05);观察组MMP-9表达水平明显高于对照组(P_(组别)<0.05);时间效应与分组效应存在明显的交互作用(P_(交互)<0.05)。结论对鼻窦炎伴鼻息肉患者,在鼻内镜术后加用布地奈德能够抑制鼻窦黏膜嗜酸性粒细胞的浸润及MMP-9的表达,这可能有助于提升患者疗效。
Objective To investigate the efficacy of budesonide and its effect on eosinophils and matrixmetalloproteinase 9 （MMP-9） expressions of paranasal sinus mucosa in the patients with sinusitis and nasalpolyps after nasal endoscopy. Metliods A total of 150 patients with sinusitis and nasal polyps who receivingnasal endoscoy were randomly divided into observation group and control group, with 75 After surgery,the observation group were administered budesonide for 3 months while the control group wastreated without budesonide. The therapeutic effect of both groups were observed. The Lund-Kennedyenn〇 scopic appearance scores before surgery, at 1 month and 3 months after surgery were assessed in bothgroups. At 1 month and 3 months after surgery,the paranasal sinus mucosa tissues were expression levels of eosinophils and （ MMP-9） were detected. Results The clinical efficacy of theobservation group was superior to that of the control group （P 〈 0. 05）. The Lund-Kennedappearance scores and eosinophils counts of both groups tended to decrease （ Ptime 〈 0. 05）. The Lund- Kennedy endoscopic appearance score and the eosinophils count of the observation group were significant lower than those of the control group （ Pg0up 〈 0. 05 ） . Interaction of time effect with group effect was observed （Pinteraction 〈 0. 05 ）. The MMP-9 expressions of paranasal sinus mucosa tissues tended to increase in both groups （ Ptime〈 0. 05 ） . The MMP-9 expression of the observation group was significant higher than that of thecontrol group （ Pgrolip 〈 0. 05 ） . Interaction of time effect with group effect was observed （ Pinteraction 〈 0. 05 ）.Conclusion For the patients with sinusitis and nasal polyps, administration of budesonide after nasal endoscopy can inhibit the eosinophils infiltration and the MMP-9 expression of in paranasal sinus mucosa, which may be helpful to improve the therapeutic effect.
作者
任朝康
黄献明
谭宇敏
周成
REN Chaokang;HUANG Xianming;TAN yumin;ZHOU Cheng(the First People＇s Hospital of Hechi,Yizhou,Guangxi 546300, Chin)
出处
《微创医学》
2018年第2期161-164,共4页
Journal of Minimally Invasive Medicine
