Lavigne François, Cameron Lisa, Renzi Paolo M, Planet Jean François, Christodoulopoulos Pota, Lamkioued Bouchaib, Hamid Qutayba
Centre Hospitalier Universitaire de Montréal-Hôspital Nôtre-Dame, McGill University Montréal, Québec, Canada.
Laryngoscope. 2002 May;112(5):858-64. doi: 10.1097/00005537-200205000-00015.
Whether instillation into the maxillary sinus of topical budesonide affected the immune response and improved allergic patients with chronic rhinosinusitis that had persistence of symptoms despite appropriate surgical intervention was assessed.
Double-blind placebo-controlled.
Twenty-six patients with allergy to house dust mites who had previously had surgery and who had persistent symptoms of disabling rhinorrhea or pressure-pain resistant to oral antibiotics and intranasal corticosteroids were recruited. During the double-blind study, patients instilled 256 microg budesonide daily or placebo through an intubation device (maxillary antrum sinusotomy tube) into one of the maxillary sinuses for 3 weeks before clinical assessment and a second biopsy.
We found an improvement in the symptom scores in 11 of the 13 patients who received budesonide; we also found a decrease in CD-3 (P = .02) and eosinophils (P = .002), and a decrease in the density of cells expressing interleukin4 (P = .0001) and interleukin-5 messenger RNA (P = .006) after treatment.
Topical budesonide delivered through a maxillary antrum sinusotomy tube can control chronic rhinosinusitis that persists after surgery.
评估经上颌窦滴注布地奈德是否会影响免疫反应，并改善尽管接受了适当手术干预但仍有症状持续的变应性慢性鼻窦炎患者的病情。
双盲安慰剂对照试验。
招募了26名对屋尘螨过敏、此前接受过手术且有持续性致残性鼻漏或压痛症状、对口服抗生素和鼻用糖皮质激素耐药的患者。在双盲研究期间，患者通过插管装置（上颌窦切开术管）每天向一侧上颌窦滴注256微克布地奈德或安慰剂，持续3周，之后进行临床评估和第二次活检。
我们发现，在接受布地奈德治疗的13名患者中，有11名患者的症状评分有所改善；我们还发现，治疗后CD-3（P = .02）和嗜酸性粒细胞（P = .002）减少，表达白细胞介素4（P = .0001）和白细胞介素-5信使核糖核酸（P = .006）的细胞密度降低。
通过上颌窦切开术管局部应用布地奈德可控制手术后持续存在的慢性鼻窦炎。
