Benítez Pedro, Alobid Isam, de Haro Josep, Berenguer Joan, Bernal-Sprekelsen Manuel, Pujols Laura, Picado Cesar, Mullol Joaquim
Rhinology Unit, Department of Otorhinolaryngology (ICEMEQ), Universitat de Barcelona, Barcelona, Spain.
Laryngoscope. 2006 May;116(5):770-5. doi: 10.1097/01.mlg.0000205218.37514.0f.
Nasal polyposis is an inflammatory disease of unknown etiology. This study aimed to evaluate the effect of a short course of oral prednisone followed by intranasal budesonide on nasal symptoms, polyp size, nasal flow, and computed tomography scan.
Eighty-four patients with severe nasal polyps were included. After a steroid washout period, patients were randomized into two groups: group A (n = 63) received oral prednisone for 2 weeks and group B (n = 21) did not receive any steroid treatment. Patients from group A received intranasal budesonide for 12 weeks.
Atopy was positive in 36.8% of patients. Blood eosinophilia was higher in asthmatic (7.2 +/- 0.7%, P < .05) than in nonasthmatic (3.0 +/- 0.4%) patients. Asthmatic patients showed higher scores on nasal obstruction and loss of smell than nonasthmatics. Oral steroids caused a significant improvement in all nasal symptoms and improved polyp size (2.1 +/- 0.1, P < .05) and nasal flow (560 +/- 35 cm/s, P < .05) compared with nontreated patients (2.8 +/- 0.1 and 270 +/- 34 cm/s, respectively). Intranasal budesonide maintained the improvement on nasal symptoms, polyp size, and nasal flow. Steroid treatment reduced the computed tomography scan score (15.4 +/- 1, P < .05) compared with before treatment (18.2 +/- 0.8).
A short course of oral steroids improved all nasal symptoms, polyp size, and nasal flow, whereas intranasal steroid maintain this effect.
鼻息肉病是一种病因不明的炎症性疾病。本研究旨在评估短期口服泼尼松后鼻内使用布地奈德对鼻部症状、息肉大小、鼻气流及计算机断层扫描的影响。
纳入84例重度鼻息肉患者。经过类固醇洗脱期后，患者被随机分为两组：A组（n = 63）接受口服泼尼松2周，B组（n = 21）未接受任何类固醇治疗。A组患者接受鼻内布地奈德治疗12周。
36.8%的患者特应性呈阳性。哮喘患者的血液嗜酸性粒细胞增多（7.2±0.7%，P <.05）高于非哮喘患者（3.0±0.4%）。哮喘患者在鼻塞和嗅觉丧失方面的评分高于非哮喘患者。与未治疗的患者（分别为2.8±0.1和270±34 cm/s）相比，口服类固醇使所有鼻部症状得到显著改善，息肉大小改善（2.1±0.1，P <.05），鼻气流改善（560±X35 cm/s，P <.05）。鼻内布地奈德维持了鼻部症状、息肉大小和鼻气流的改善。与治疗前（18.2±0.8）相比，类固醇治疗降低了计算机断层扫描评分（15.4±1，P <.05）。
短期口服类固醇改善了所有鼻部症状、息肉大小和鼻气流，而鼻内类固醇维持了这种效果。
