摘要
目的测定季节性变应性鼻炎(SAR)和血管运动性鼻炎(VMR)的鼻一氧化氮(nNO),探讨其临床应用价值。方法选择SAR患者33例和VMR患者30例作为实验组,同期选择30名健康成年人作为对照组。测量纳入对象的nNO,采用皮肤点刺试验或sIgE检测评估过敏状态,并检测外周血嗜酸性粒细胞和血清tIgE。运用视觉模拟评分量表评价患者鼻部症状严重程度。实验组以糠酸莫米松鼻喷雾剂治疗,4周后重复测量和评分。结果 SAR患者nNO浓度754.2[610.0;851.5]ppb明显高于VMR患者498.2[456.8;535.3]ppb及正常对照组434.5[406.0;455.3]ppb(P<0.001);SAR组nNO、外周血EOS%、tIgE水平高于另两组。nNO值与外周血EOS%、鼻部症状VAS评分、tIgE无相关性。实验组在治疗4周后nNO值与治疗前比较,差异有统计学意义(P<0.001)。结论 nNO可将SAR患者与健康人较好地区分;VMR患者较正常人nNO浓度增高,这提示一部分VMR可能有局部鼻黏膜变态反应存在;鼻用皮质类固醇治疗后nNO水平下降,并与鼻部症状评分下降趋势一致,表明nNO可以作为反映鼻炎患者黏膜炎症好转的指标。
Objective To determine the nasal nitric oxide(nNO)in patients with seasonal allergic rhinitis(SAR)and vasomotor rhinitis(VMR)and discuss its clinical application value.Methods 33 patients with SAR and 30 patients with VMR were selected as the experimental group,while 30 healthy adults were selected as the control group during the same period.The nNO of the included subjects was measured,and the allergic status was assessed by skin prick test or sIgE test,and peripheral blood eosinophils(EOS%)and serum tIgE were detected.Visual analogue scale(VAS)was used to evaluate the severity of nasal symptoms.The experimental group was treated with mometasone furoate nasal spray,and measured and scored again 4 weeks later.Results The concentration of nNO in SAR patients(754.2[610.0;851.5])was significantly higher than that in VMR patients(498.2[456.8;535.3])and control group(434.5[406.0;455.3]).The levels of nNO,EOS%and tIgE in SAR group were higher than those in the other two groups.There is no correlation between nNO and EOS%,VAS and tIgE.The nNO of the experimental group after 4 weeks of treatment was statistically significant compared with that before treatment(P<0.001).Conclusions The nNO can be used to distinguish SAR patients from healthy people;The nNO in VMR patients was higher than that in healthy people,suggesting that some VMR patients may have local allergic reaction in nasal mucosa.The nNO decreased after nasal corticosteroid treatment,and nNO showed the same trend as VAS,indicating that nNO could be used as an indicator to reflect the improvement of mucosa inflammation in patients with rhinitis.
作者
胡娟
周天豪
吕芸
何健
Hu Juan;Zhou Tianhao;Lv Yun;He Jian(Department of Otolaryngology Head and Neck Surgery,The first clinical medical college of Gansu University of Chinese Medicine,Gansu,Lanzhou,730000;Gansu Provincial Hospital,,Lanzhou,Gansu Province,730000,China)
出处
《中国医学文摘（耳鼻咽喉科学）》
2020年第6期433-437,F0003,共6页
Chinese Medical Digest(Otorhinolaryngology)
