大环内酯类药物治疗慢性鼻-鼻窦炎的进展

A progress of macrolides therapy for chronic rhinosinusitis

慢性鼻-鼻窦炎（chronic rhinosinusitis,CRS）是一类累及鼻及鼻窦的、包括多种临床类型的感染性及炎症性疾病。其发病人群巨大,严重影响患者生活质量。目前对CRS的治疗多为局部鼻喷激素、口服激素、手术治疗等-[1]。但因CRS病理类型不同,任何一种单一治疗方法均不能使所有CRS患者的症状得到有效缓解。大环内酯类药物是具有大环内酯环的一类抗生素,通常是14、15或16元环的亲酯类抗生素,口服具有良好的生物利用度。

Macrolides are a type of antibiotics with macrocyclic lactone ring,which have been commonly used in the treatment of diffuse panbronchiolitis,chronic obstructive pulmonary disease,bronchial asthma,cystic fibrosis and other diseases.Macrolides not only have effect on antibacterial,but also effect on anti-inflammatory and immunoregulation.Chronic rhinosinusitis（CRS）is a common disease entity of infectious and inflammatory diseases that involved in nasal cavity and nasal sinuses,with various clinical phenotypes.With the high prevalence of CRS,it seriously affects the quality of patients＇ life.In recent years,a large number of studies have shown that long-term low-dose macrolides are effective in parts of patients with CRS.Although the mechanism of macrolides for CRS has not yet been clarified.According to recent studies,it might be related with anti-inflammatory or immunoregulation of macrolides and the different phenotypes of CRS.The safety and mechanism of long-term macrolides are needed further clarification.