Naraghi Mohsen, Deroee Armin Farajzadeh, Ebrahimkhani MohammadReza, Kiani Samira, Dehpour AhmadReza
Iranian Rhinology Research Society, Department of Otorhinolaryngology, Head and Neck surgery & Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Am J Otolaryngol. 2007 Sep-Oct;28(5):334-7. doi: 10.1016/j.amjoto.2006.10.014.
Exhaled NO is produced mainly in paranasal sinuses and nasal mucosa. Nasal NO has been suggested to have a variety of effects in nasal cavity. Decreased exhaled NO is found in chronic sinusitis, and NO metabolite levels are increased in animal models of chronic sinusitis, suggesting a role for them in sinusitis pathogenesis. There was no data available on human NO metabolite level.
We lavaged maxillary sinuses in a control and 2 patient groups. The control group was patients who underwent functional endoscopic sinus surgery (FESS) due to any other reason than chronic sinusitis. The patient groups had chronic rhinosinusitis with and without polyposis who underwent FESS. Maxillary sinuses were lavaged during FESS, and NO metabolites (nitrate and nitrite) were lavaged in the lavage fluid.
Nitric oxide metabolite levels (mean +/- SEM) were 8.085 +/- 1.43 mumol/L in healthy maxillary sinus lavage fluid and 18.04 +/- 3.51 and 16.78 +/- 2.91 mumol/L in chronic rhinosinusitis with and without polyposis, respectively. Lavage fluid of sinuses with chronic sinusitis had elevated levels of NO metabolites, which were significantly higher than the control group. The difference between the chronic sinusitis with and without polyposis groups was not significant.
Nitric oxide metabolites were significantly higher in maxillary sinuses of patients with chronic sinusitis. Elevated levels of NO and NO metabolites in sinusitis might damage healthy sinus epithelium. NO metabolites may have an important role in sinusitis pathogenesis.
呼出一氧化氮（NO）主要产生于鼻窦和鼻黏膜。有研究表明，鼻腔一氧化氮在鼻腔中具有多种作用。慢性鼻窦炎患者呼出的一氧化氮水平降低，而在慢性鼻窦炎动物模型中，NO代谢产物水平升高，提示它们在鼻窦炎发病机制中发挥作用。目前尚无关于人类NO代谢产物水平的数据。
我们对对照组和两组患者的上颌窦进行灌洗。对照组为因慢性鼻窦炎以外的任何其他原因接受功能性鼻内镜鼻窦手术（FESS）的患者。患者组为患有或不患有息肉的慢性鼻-鼻窦炎患者，均接受了FESS。在FESS期间对上颌窦进行灌洗，并对灌洗液中的NO代谢产物（硝酸盐和亚硝酸盐）进行检测。
健康上颌窦灌洗液中一氧化氮代谢产物水平（平均值±标准误）为8.085±1.43μmol/L，患有和不患有息肉的慢性鼻-鼻窦炎患者的该水平分别为18.04±3.51μmol/L和16.78±2.91μmol/L。患有慢性鼻窦炎的鼻窦灌洗液中NO代谢产物水平升高，显著高于对照组。患有和不患有息肉的慢性鼻窦炎组之间的差异不显著。
慢性鼻窦炎患者上颌窦中的一氧化氮代谢产物显著升高。鼻窦炎中NO及其代谢产物水平升高可能会损害健康的鼻窦上皮。NO代谢产物可能在鼻窦炎发病机制中起重要作用。
