口服和鼻内类固醇治疗可改善鼻腔通畅度，并在严重鼻息肉患者中反常地增加鼻内一氧化氮。
Oral and intranasal steroid treatments improve nasal patency and paradoxically increase nasal nitric oxide in patients with severe nasal polyposis.
机构信息
Rhinology Unit and Smell Clinic, Department of Otorhinolaryngology, Hospital Clinic i Universitari, Barcelona, Spain.
出版信息
Rhinology. 2012 Jun;50(2):171-7. doi: 10.4193/Rhin10.140.
INTRODUCTION
Recently, we demonstrated that acoustic rhinometry (AR) measurements correlated with nasal cavity volumes in patients with nasal polyposis (NP). The aim of the present study was to evaluate whether AR and nasal nitric oxide (nNO) are useful methods in monitoring and follow-up of medical treatment of NP.
MATERIAL AND METHODS
Patients with severe nasal polyps were randomized into two groups after a 4-week steroid washout period (w0): a treatment group received oral prednisone for 2 weeks (w2) and intranasal budesonide for 12 weeks (w12) while the control group received no steroid treatment. Nasal volume (Vol 0-6), minimum cross-sectional area (mCSA), nNO, peak nasal inspiratory flow (PNIF), nasal obstruction, and smell loss were evaluated.
RESULTS
At w2, the treatment group showed a significant increase of vol 0-6 compared to w0 and the control group. The mCSA area also increased compared to w0 and the control group. At w12, the improvement in vol 0-6 and mCSA was maintained after intranasal steroids compared to w0. At w2, the treatment group showed a paradoxical increase of nNO compared to w0 and the control group. At w12, this increase was maintained by intranasal steroids.
CONCLUSION
Both oral and intranasal steroid treatments improve nasal patency and paradoxically increase nNO, by opening the ostiomeatal complex. This suggests that AR and nNO are useful methods in the monitoring and follow-up of patients with NP.
简介
最近，我们证明了声鼻测量（AR）测量与鼻息肉（NP）患者的鼻腔容积相关。本研究的目的是评估 AR 和鼻内一氧化氮（nNO）是否可用于监测和随访 NP 的医学治疗。
材料和方法
经过 4 周的类固醇洗脱期（w0）后，将严重鼻息肉患者随机分为两组：治疗组在 w2 时接受口服泼尼松治疗 2 周，在 w12 时接受鼻内布地奈德治疗 12 周；而对照组则不接受类固醇治疗。评估了鼻腔容积（Vol 0-6）、最小横截面积（mCSA）、nNO、峰值鼻吸气流量（PNIF）、鼻塞和嗅觉丧失。
结果
在 w2 时，治疗组与 w0 和对照组相比，vol 0-6 显著增加。mCSA 面积也比 w0 和对照组增加。在 w12 时，与 w0 相比，经鼻内类固醇治疗后，vol 0-6 和 mCSA 的改善得以维持。在 w2 时，与 w0 和对照组相比，治疗组的 nNO 出现了反常增加。在 w12 时，经鼻内类固醇治疗后，这种增加得以维持。
结论
口服和鼻内类固醇治疗均能改善鼻腔通畅度，并通过开放耳窦复合体，反常性地增加 nNO。这表明 AR 和 nNO 是监测和随访 NP 患者的有用方法。
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