局部应用于鼻黏膜的羟甲唑啉可减少中耳的经黏膜氧化亚氮交换。
Oxymetazoline Applied Topically to the Nasal Mucosa Decreases Trans-Mucosal Nitrous Oxide Exchange for the Middle Ear.
作者信息
Teixeira Miriam S, Alper Cuneyt M, Martin Brian S, Helal Narmin, Doyle Brendan M Cullen, Doyle William J
机构信息
Department of Otolaryngology, School of Medicine of the University of Pittsburgh, Pittsburgh, Pennsylvania, USA
Department of Otolaryngology, School of Medicine of the University of Pittsburgh, Pittsburgh, Pennsylvania, USA Department of Pediatric Otolaryngology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA.
出版信息
Ann Otol Rhinol Laryngol. 2016 May;125(5):400-7. doi: 10.1177/0003489415617776. Epub 2015 Nov 26.
OBJECTIVE
Determine if the middle ear (ME) trans-mucosal nitrous oxide (N2O) gas exchange rate can be pharmacologically modulated by the nasal application of a vasoconstrictor.
METHODS
In a randomized, double-blind, crossover study, 20 adults received a nasal spray challenge containing either oxymetazoline or saline (placebo). At each session, subjects were fitted with a non-rebreathing mask and breathed room air for 20 minutes, 50% N2O:50% O2 for 20 minutes, and 100% O2 for 10 minutes. Throughout, heart rate, blood pressure (BP), and blood O2 saturation were monitored, and bilateral ME pressure was recorded by tympanometry every minute. The primary outcome measure was the slope of the ME pressure-time function for the experimental period, a direct measure of the transMEM N2O exchange constant. The effects of treatment, session, and period on the measured vital signs and of treatment, session, disease history, and ear on the ME pressure-time slopes were evaluated for statistical significance using repeated measures ANOVAs.
RESULTS
The analysis documented a significant effect of period on O2 saturation (N2O > room air, P = .03) and of treatment on blood pressure (oxymetazoline > placebo, P < .02) and the ME pressure-time slope (placebo > oxymetazoline, P = .05).
CONCLUSION
The exchange rate across the ME mucosa of inert gases can be decreased by topical treatment of the nasal mucosa with oxymetazoline.
目的
确定通过鼻腔应用血管收缩剂是否能对中耳（ME）跨黏膜一氧化二氮（N₂O）气体交换率进行药理学调节。
方法
在一项随机、双盲、交叉研究中，20名成年人接受了含有羟甲唑啉或生理盐水（安慰剂）的鼻腔喷雾激发试验。在每个试验阶段，受试者佩戴无重复呼吸面罩，先呼吸室内空气20分钟，再呼吸50% N₂O:50% O₂混合气体20分钟，最后呼吸100% O₂ 10分钟。在此过程中，监测心率、血压（BP）和血氧饱和度，并通过鼓室图每分钟记录双侧中耳压力。主要观察指标是试验期内中耳压力 - 时间函数的斜率，这是跨中耳黏膜N₂O交换常数的直接测量指标。使用重复测量方差分析评估治疗、试验阶段和时间段对所测生命体征的影响，以及治疗、试验阶段、病史和耳部情况对中耳压力 - 时间斜率的影响，以确定统计学意义。
结果
分析表明，时间段对血氧饱和度有显著影响（N₂O > 室内空气，P = 0.03），治疗对血压（羟甲唑啉 > 安慰剂，P < 0.02）和中耳压力 - 时间斜率（安慰剂 > 羟甲唑啉，P = 0.05）有显著影响。
结论
用羟甲唑啉局部治疗鼻黏膜可降低惰性气体跨中耳黏膜的交换率。
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