布地奈德喷鼻治疗变应性鼻炎儿童鼻分泌物嗜酸性粒细胞的变化

Changes of Eosinophil in Nasal Secretion of Children with Allergic Rhinitis before and after Treatment with Budesonide Nasal Spray

目的探讨变应性鼻炎(AR)儿童在接受布地奈德喷鼻治疗前后鼻分泌物涂片嗜酸性粒细胞(EOS)百分比(EOS%)的变化。方法收集确诊为持续性AR且近1个月内未接受布地奈德喷鼻治疗的92例儿童为研究对象。对其症状、体征进行评分,检查其鼻分泌物EOS%。予布地奈德喷鼻治疗,并于布地奈德喷鼻治疗前与喷鼻治疗1个月、治疗2个月进行其鼻分泌物EOS%检查,观察其变化。同时根据症状、体征评分判定疗效。结果 1.布地奈德喷鼻治疗1个月总有效率为84.78%,治疗2个月总有效率为94.57%,二者比较差异有统计学意义(χ2=6.197,P=0.045)。2.治疗前鼻分泌物EOS%重度的67例患儿,治疗1个月48例鼻分泌物EOS%下降,治疗2个月64例鼻分泌物EOS%下降,治疗2个月鼻分泌物EOS%下降率显著高于治疗1个月(χ2=12.240,P<0.001)。治疗前鼻分泌物EOS%中度的17例患儿中,治疗1个月12例鼻分泌物EOS%下降,治疗2个月16例鼻分泌物EOS%下降,治疗1个月与2个月的鼻分泌物EOS%下降率比较差异无统计学意义(χ2=3.690,P>0.05)。结论 EOS为AR的主要炎性细胞之一,布地奈德喷鼻剂能迅速降低AR患儿鼻分泌物中EOS比例,鼻分泌物EOS%可作为儿童AR疗效判定的指标。

Objective To explore the changes of eosinophil percentage（EOS%） in nasal secretion of children with allergic rhinitis（AR） before and after treatment with budesonide nasal spray.Methods Ninety-two children with AR who had not received budesonide therapy in 1 month were included in this study,and they were treated with budesonide nasal spray.EOS% in nasal secretion was counted,and the therapeutic effect at the time-points,1 month and 2 months after treatment were judged,respectively.Results 1.The efficiency of the 1 month after treatment with budesonide was 84.78%,and the efficiency of the 2 months after treatment was 94.57%,there was a significant difference（χ2=6.197,P=0.045）.2.The children with rate of EOS%0.50 in the nasal secretion was 67 cases,48 cases and 64 cases declined after 1 month and 2 months treatment,respectively（χ2=12.240,P0.001）;The children with the rate of EOS% 0.10-0.15 in the nasal secretion was 17 cases,12 cases and 16 cases declined after 1 month and 2 months treatment,respectively（χ2=3.690,P0.05）.Conclusions Eosinophil is the major inflammatory cell in allergic rhinitis.Application of budesonide spray can decrease EOS% in nasal secretion of children with AR.Detection of EOS in nasal secretion may be an index for judging the therapeutic effect on AR.