局部糖皮质激素对慢性鼻窦炎的鼻-鼻窦黏膜功能的影响

Influence of Topical Glucocorticosteroid on Rhino-sinus Mucosa in Chronic Sinusitis

【目的】观察慢性鼻窦炎局部使用糖皮质激素治疗前后,鼻-鼻窦黏膜纤毛传输功能的变化。【方法】对60例使用雷诺考特鼻喷雾剂治疗的慢性鼻窦炎门诊患者,分别于治疗前、治疗后3个月、治疗后6个月进行糖精试验,并与健康对照组进行比较。【结果】试验组使用雷诺考特鼻喷雾剂治疗前纤毛传输速率(MTR),与健康对照组比较差异有显著性(P<0.01);使用雷诺考特鼻喷雾剂治疗后3个月的MTR,与使用雷诺考特鼻喷雾剂治疗前比较差异有显著性(P<0.01);使用雷诺考特鼻喷雾剂治疗后6个月的MTR,与使用雷诺考特鼻喷雾剂治疗前、使用雷诺考特鼻喷雾剂治疗后3个月比较差异均有显著性(P<0.01);而与健康对照组比较差异无显著性(P>0.05)。6个月后所有患者症状完全消失,鼻内镜检查发现鼻黏膜充血明显减轻,分泌物消失,黏膜正常化。复查鼻窦CT可见窦腔内的低密度影消失,黏膜变薄。【结论】慢性鼻窦炎的鼻-鼻窦黏膜纤毛的清除功能明显受损,局部糖皮质激素能很好地恢复慢性鼻窦炎鼻-鼻窦黏膜功能。

[Objective]To investigate the functional changes of mucociliary transport both pre-therapy and post-therapy in chronic sinusitis（CS） treated with topical glucocorticosteroid. [Methods] Saccharin test of nasal mucosa was taken in 60 cases with CS before, three months and six months after treatment with Rhinocort and in 30 normal subjects as controls. [Results]The average mucociliary transport rate （MTR） in patients with CS before treatment with Rhinocort was significant difference compared with the controls （ P 〈0.01）, The average MTR in patients with CS three months after treatment with Rhinocort was significant difference compared with the patients with CS before treatment （ P 〈0.01）. The average of MTR in patients with CS six months after treatment with Rhinocort was significant difference compared with the patients with CS before and three months after treatment （ P 〈0.01）, while there was no significant difference compared with the controls （ P 〉0.05）, Six months after treatment with Rhinocort, the symptom of all cases with CS disappeared completely. Nasal mucosa was obviously decongested, the secretion vanished, the mucosa became nor malization by nasal endoscopy, and low-density shadow in the paranasal sinus disappeared and the mucosa be came thin by CT scan. [Conclusion] The clearance function of rhino-sinus mucosa in patients with CS is impaired significantly, and topical glucocorticosteroid can improve the mucociliary clearance function of rhino-sinus mucosa.