鼻用糠酸莫米松喷雾剂联合克拉霉素对慢性鼻窦炎鼻窦内窥镜手术患者鼻气道阻力及血清干扰素γ肿瘤坏死因子α的影响

Effects of nasal mometasone furoate spray combined with clarithromycin on nasal airway resistance and serum IFN-γand TNF-αin patients with chronic sinusitis after endoscopic sinus surgery

目的探究鼻用糠酸莫米松喷雾剂联合克拉霉素对慢性鼻窦炎鼻窦内窥镜手术患者鼻气道阻力及血清干扰素γ(IFN-γ)、肿瘤坏死因子α(TNF-α)的影响。方法回顾性分析2022年2月至2023年12月期间,浙江省金华市中心医院收治的慢性鼻窦炎鼻窦内窥镜手术患者共计108例,根据患者接受治疗方案的不同进行分组,其中接受克拉霉素治疗的研究对象被纳入常规干预组(55例);接受鼻用糠酸莫米松喷雾剂联合克拉霉素治疗的研究对象被纳入联合干预组(53例);记录2组研究对象接受干预后的鼻气道阻力、鼻黏液纤毛清除率、鼻黏液纤毛清除速度、IFN-γ、TNF-α水平、临床症状(鼻塞、流涕、头痛、嗅觉减退)评分、接受干预后用药不良反应发生率,并进行比较。结果2组研究对象接受干预后,鼻气道阻力出现下降,联合干预组低于常规干预组(P<0.05);鼻黏液纤毛清除率、鼻黏液纤毛清除速度上升,联合干预组高于常规干预组(P<0.05);干预后2组血清IFN-γ、TNF-α水平下降,联合干预组低于常规干预组(P<0.05);干预后各维度临床症状(鼻塞、流涕、头痛、嗅觉减退)评分较干预前均下降,联合干预组低于常规干预组(P<0.05);2组不良反应发生率差异无统计学意义(P>0.05)。结论鼻用糠酸莫米松喷雾剂联合克拉霉素应用于慢性鼻窦炎鼻窦内窥镜手术患者能够有效降低鼻气道阻力、缓解炎性反应,且不增加用药不良反应,具有较高的应用价值。

ObjectiveTo explore the effects of nasal mometasone furoate spray combined with clarithromycin on nasal airway resistance and serum interferonγ(IFN-γ)and tumor necrosis factorα(TNF-α)in patients with chronic sinusitis after endoscopic sinus surgery.MethodsA retrospective analysis was conducted on a total of 108 patients with chronic sinusitis who underwent endoscopic sinus surgery in Jinhua Central Hospital from February 2022 to December 2023.According to different treatment regimens,they were divided into a conventional inter-vention group(55 cases)and a combined intervention group(53 cases).The conventional intervention group re-ceived clarithromycin treatment;the combined intervention group was treated with nasal mometasone furoate spray combined with clarithromycin.The nasal airway resistance,clearance rate and speed of nasal mucous cilia,levels of serum IFN-γand TNF-α,scores of clinical symptoms(nasal congestion,runny nose,headache,hyposmia)and incidence of adverse drug reactions in the two groups were recorded and compared after intervention.ResultsAfter intervention,nasal airway resistance was significantly decreased in both groups,which was lower in combined intervention group than conventional intervention group(P<0.05).After intervention,clearance rate and speed of nasal mucous cilia were significantly increased in both groups,which were higher in combined inter-vention group than conventional intervention group(P<0.05).After intervention,levels of serum IFN-γand TNF-αwere signifi-cantly decreased in both groups,which were lower in combined intervention group than conventional intervention group(P<0.05).After intervention,scores of clinical symptoms(nasal congestion,runny nose,headache,hyposmia)were decreased in both groups,which were lower in combined intervention group than conventional intervention group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).ConclusionNasal mometasone furoate spray combined with clarithromycin can effectively reduce nasal airway resistance and alleviate inflammatory response in patients with chronic sinusitis after nasal endoscopic surgery,which has low incidence of adverse drug reactions.