Bülbül T, Bülbül O Gümüştekin, Güçlü O, Bilsel A Serpil, Gürsan S Önal
Department of Otorhinolaryngology, Haydarpaşa Numune Education and Research Hospital, Istanbul, Turkey.
J Laryngol Otol. 2013 Jun;127(6):584-9. doi: 10.1017/S002221511300073X. Epub 2013 Apr 15.
To investigate endoscopic staging, and nitric oxide levels in the polyp tissue, in patients with nasal polyposis undergoing glucocorticoid therapy.
Nasal polyposis was evaluated using endoscopic staging and measurement of polyp tissue nitric oxide levels (chemiluminescence method). Forty-five nasal polyposis patients received either nasal therapy (n = 15), oral therapy (n = 15) or combined therapy (n = 15). Pre-treatment and post-treatment staging and nitric oxide levels were evaluated.
Endoscopic grading indicated significant post-treatment staging improvements in the oral (p = 0.016) and combined (p = 0.016) groups. Post-treatment staging differed significantly between the three groups (p = 0.041), with greater improvements in the oral and combined groups. All groups showed significantly lower post-treatment nitric oxide levels, compared with baseline, but post-treatment levels did not differ significantly between groups. A significant association was found between treatment response and nitric oxide level alteration.
This study demonstrates the favourable effects of glucocorticoids on nasal polyposis, and alteration in nitric oxide tissue levels post-treatment. Nitric oxide level in nasal polyp tissue could be an indicator of treatment response, and may aid surgical decision-making by detecting cases that probably will not respond to medical treatment.
研究接受糖皮质激素治疗的鼻息肉患者的内镜分期及息肉组织中的一氧化氮水平。
采用内镜分期及测量息肉组织一氧化氮水平（化学发光法）对鼻息肉进行评估。45例鼻息肉患者分别接受鼻腔治疗（n = 15）、口服治疗（n = 15）或联合治疗（n = 15）。评估治疗前和治疗后的分期及一氧化氮水平。
内镜分级显示口服组（p = 0.016）和联合组（p = 0.016）治疗后的分期有显著改善。三组治疗后的分期差异有统计学意义（p = 0.041），口服组和联合组改善更大。与基线相比，所有组治疗后的一氧化氮水平均显著降低，但组间治疗后水平差异无统计学意义。发现治疗反应与一氧化氮水平改变之间存在显著关联。
本研究证明了糖皮质激素对鼻息肉的良好效果以及治疗后一氧化氮组织水平的改变。鼻息肉组织中的一氧化氮水平可能是治疗反应的一个指标，并且通过检测可能对药物治疗无反应的病例，可能有助于手术决策。
