糖皮质激素对鼻黏膜放射性损伤后黏液纤毛传输功能的影响

Effect of intranasal glucocorticoids on human nasal mucociliary transport after radiotherapy

目的观察鼻腔局部应用糖皮质激素对鼻黏膜放射性损伤后黏液纤毛传输功能的影响,探讨糖皮质激素治疗在鼻黏膜放射性损伤中的作用。方法 38例鼻咽癌患者随机分为实验组和对照组,实验组于放疗开始后给予布地奈德鼻腔局部治疗,采用糖精试验分别测定放疗前及放疗后各阶段的鼻腔黏液纤毛传输时间(mucociliary transport time,MTT)。对照组除不使用布地奈德,其他治疗均与实验组一样。结果两组中放疗后各阶段鼻腔MTT较放疗前显著延长,呈时间依赖性;放疗后各阶段实验组和对照组的MTT比较有统计学意义,鼻腔局部使用糖皮质激素能显著减少放疗后鼻腔黏液纤毛传输时间。结论鼻腔应用糖皮质激素对鼻黏膜放射性损伤后黏液纤毛传输功能具有一定的保护作用。

Objective To observe the influence of intranasal glucecorticoids on the transmission capability of mucocilia in irradiated nasal mucosa, and to study the radioprotective effect of intranasal glucocorticoids. Methods Thirty-eight patients with nasopharyngeal carcinoma were randomly divided into experimental group and control group. All the patients of the experimental group received topical budesonide nasal spray during the period of radiotherapy, while those of the control group received no budesonide nasal spray. Mucociliary transport time （ MTT ） were detected in both groups before radiotherapy and at 5 time points during or after radiotherapy. Results Being compared with the MTT before radiotherapy, the MTT of both groups increased with time and reached the maximum at 6 months after radiotherapy. The differenees of MTT between the two group were significant. Intranasal glucocorticoids spray could significantly decrease the prolongation of MTT caused by radiotherapy. Conclusion Intranasal glucocorticoids may play a role in the protection of nasal mucosa from radiation.