二性霉素B鼻腔冲洗对鼻息肉作用的观察

Effect of Amphotericum B Nasal Lavage on Nasal Polyposis

目的评价鼻息肉患者经鼻内激素喷雾治疗后,对抗真菌药鼻腔冲洗的反应。方法该研究包括70例患者,其中男性46例,女性24例,平均年龄46岁。所有患者均常规应用类固醇喷鼻剂喷鼻(400μg/d)至少1月以上。抗真菌治疗前,鼻息肉分级为:1级12例(17%),2级46例(66%),3级12例(17%)。将1ml二性霉素B以1000ml蒸馏水稀释。用上述稀释液20ml冲洗每侧鼻腔,2次/d,共4wk。结果二性霉素B药液冲洗鼻腔后,25例(35.7%)鼻息肉消失,其中鼻息肉分级为1级者7例(58%),2级18例(39%)。鼻息肉3级者对抗真菌剂冲洗治疗无反应。结论二性霉素B药液冲洗鼻腔对鼻息肉有治疗作用。由于35.7%患者对抗真菌剂冲洗鼻腔反应良好,对真菌免疫反应可能为鼻息肉发展的机制之一。

Purpose To evaluate the response of patients with NP already treated by intranasal corticoid spray to anti-fungal nasal lavages. Methods Seventy patients, 24 females and 46 males with a mean age of 46 years were included in this study. All patients had received on their conventional topical corticoid spray(400 μg/day). Before anti-fungal treatment, the distribution of NP staging was: 12 patients in stage Ⅰ(17%) ,46 patients in stage Ⅱ (66%)and 12 patients in stage Ⅲ(17% ) . One milliliter of amphotericum B was diluted in 1 000 ml of distilled water. The patients underwent nasal lavage with 20ml of this preparation in each nostril, twice a day, during 4 weeks. Results After the anti-fungal lavages, total disappearance of NP was observed in 25 patients( 35.7 %). Among this group of cured patients ,7(58%) were in stage Ⅰ and 18 (39%) were in stage Ⅱ. No patients in stage Ⅲ had responded to the lavages. Conclusion Since 35.7% of patients responded very well to anti-fungal nasal lavage, an immune response to fungal organisms could be one mechanism underline the development of NP.