克拉霉素治疗CRSwNP的临床效果及对鼻黏膜组织中VEGF水平变化的影响

Analysis of the effect of clarithromycin on VEGF in CRSwNP tissue and its clinical efficacy

目的 :探讨克拉霉素对慢性鼻-鼻窦炎伴鼻息肉(CRSwNP)患者鼻黏膜血管内皮生长因子(VEGF)的影响以及其临床疗效。方法 :选取2015年6月~2016年6月在我院接受药物治疗的CRSwNP患者121例,将患者随机分为观察组(n=64)和对照组(n=56),对照组给予常规治疗,观察组在对照组基础上给予克拉霉素,观察两组治疗疗效。结果 :A组处理前黏膜组织VEGF蛋白表达明显高于B组;给予克拉霉素后,A组和B组黏膜组织VEGF蛋白表达较处理前明显降低;观察组治疗疗效明显优于对照组,其中观察组和对照组治愈率分别为50.00%和29.82%;观察组治疗后鼻塞、流涕、头痛和嗅觉减退评分分别为(2.41±1.12)分、(3.31±1.51)分、(1.85±0.94)分和(2.60±1.10)分,明显低于对照组;观察组和对照组治疗期间未发现有严重不良反应发生。结论 :克拉霉素治疗CRSwNP疗效较好,其可能是通过抑制VEGF的表达而起作用。

Objective To investigate the effect of clarithromycin on chronic rhinosinusitis with nasal polyps(CRSwNP) nasal mucosa vascular endothelial growth factor(VEGF) and its clinical efficacy. Methods Selected 32 patients with CRSwNP who underwent endoscopic sinus surgery in our hospital from January to May 2015(A group), 30 patients with simple nasal who underwent septum deviation correction of nasal septum surgery(B group), immunohistochemical method was used to detect the expression of VEGF of clindamycin on mucosal tissue; selected 121 patients with CRSwNP who received drug therapy in our hospital from June 2015 to June 2016, were randomly divided into observation group(n=64) and control group(n=56), the control group was given routine treatment, the observation group was given clarithromycin on the basis of control group, observed the treatmen curative effect oft two group. Results A group before treatment VEGF protein expression of mucosa was significantly higher than B group; given clarithromycin, VEGF protein expression of mucosal tissue in A group and B group were significantly lower than before treatment; The observation group curative effect was better than the control group, the observation group and control group cure rate were 50.00% and 29.82%; The observation group after treatment Stuffy nose,, runny nose, headache and hyposmia scores were(2.41±1.12) points,(3.31±1.51) points,(1.85±0.94) points and(2.60±1.10) points, significantly lower than the control group; No serious adverse reactions were found in the observation group and control group during the treatment. Conclusion Clarithromycin in the treatment of CRSwNP has a good curative effect, it may play a role by inhibiting the expression of VEGF.