常用减充血剂对鼻黏膜纤毛毒性的观察

The observation of the ciliotoxicity of nasalmucosal with nasal decongestant

目的:观察减充血剂对鼻黏膜纤毛的毒性作用,为临床选择合适的鼻腔减充血剂提供参考。方法:①选健康志愿者100例,分别用0.05%、0.025%盐酸羟甲唑啉,1.0%、0.5%麻黄素喷鼻7d,进行糖精试验以检测鼻黏膜纤毛输送率(MTR),并与对照组进行比较。②用药7d后每组各取1例下鼻甲黏膜进行扫描电镜观察。结果:①用药7d后,0.05%盐酸羟甲唑啉组鼻黏膜纤毛MTR为(7.64±1.56)mm/min;0.025%盐酸羟甲唑啉组为(7.46±1.65)mm/min,其差异无统计学意义(P>0.05);1.0%麻黄素组为(4.73±2.03)mm/min;0.5%麻黄素组为(4.38±2.04)mm/min,其差异亦无统计学意义(P>0.05)。0.05%、0.025%盐酸羟甲唑啉组分别与对照组[(7.14±1.76)mm/min]比较,差异无统计学意义(均P>0.05);1.0%、0.5%麻黄素组分别与对照组比较,差异有统计学意义(均P<0.01)。0.05%、0.025%盐酸羟甲唑啉组分别与1.0%、0.5%麻黄素组比较,差异有统计学意义(均P<0.05)。②电镜观察:1.0%、0.5%麻黄素组黏膜上皮纤毛脱落,0.05%、0.025%盐酸羟甲唑啉组纤毛排列整齐。结论:麻黄素对鼻黏膜纤毛有不良影响;盐酸羟甲唑啉对鼻黏膜纤毛无明显影响,没有破坏鼻黏膜纤毛的正常生理功能,是理想的鼻腔减充血剂。

Objective： To study the ciliotoxicity of nasalmucosal with nasal decongestant, in order to choose the appropriate nasal decongestant. Method：①Selected 100 healthy volunteers, by using 0. 05% hydrochloride oxymetazoline,0. 025% hydrochloride oxymetazoline, 1.0% ephedrine and 0.5% ephedrine for 7 days with sacchariu technique to test nasal mucociliary transport,and compared with the normal saline. ②To observe the mucosa of inferior turbinate with Electron Microscopy. Result：After using nasal decongestant for 7 days, Mean nasal mucociliary transport rat （MTR） in 0.05% hydrochloride oxymetazoline groups was （7.64±1.56）mm/min and （7.46±1. 65）mm/min in 0.25% hydrochloride oxymetazoline groups, Mean nasal mucociliary transport rat （MTR） in 1.0% ephedrine groups was （4.73±2.03） mm/min and （4.38±2.04） mm/min in 0.5% ephedrine groups,The normal saline groups was （ 7. 14±1. 76 ） mm/min. MTR was obviously different （F=16.50, P〈0.01 ）. ②With electron microscopy, it was found that the cilia of epithelial cells were in good order, uniformed in hydrochloride oxymetazoline groups and exfoliated in ephedrine groups. Conclution： Ephedrine has ill effects on nasal mucosa; Hydrochloride oxymetazoline has neither effect on nasal mucosa, nor destroying the physical function of nose, it is an ideal nasal decongestant .