ENT Department, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China.
ENT Department, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China.
Am J Med Sci. 2020 Aug;360(2):137-145. doi: 10.1016/j.amjms.2020.04.024. Epub 2020 Apr 25.
At present, the effect of operation intervention on pulmonary function is not clear in patients with allergic rhinitis and chronic rhinosinusitis with nasal polyps (AR&CRSwNP). This study was conducted to investigate the effect of vidian neurectomy on pulmonary function and airway hyperresponsiveness (AHR) in patients with AR&CRSwNP.
The incidences of AHR, bronchial asthma (BA) and pulmonary function impairment in 112 patients with AR&CRSwNP were investigated. Subsequently, we evaluated the outcome of vidian neurectomy and its effect on pulmonary function and AHR. Furthermore, we explored the correlation between postoperative level of eosinophilic cationic protein (ECP) and the changes of pulmonary function indices or dose of methacholine.
In this study, the incidences of pulmonary function impairment, bronchial asthma, and AHR in patients with AR&CRSwNP were 61.61%, 69.64%, and 66.96%, respectively. Particularly, vidian neurectomy effectively alleviated nasal symptoms, improved pulmonary function, and reduced AHR in AR&CRSwNP patients. Furthermore, the postoperative level of ECP, IgE, Interleukin-4 and Interleukin-IL-5 was dramatically decreased, and there was an obvious inverse correlation between ECP level and pulmonary function index or dose of methacholine.
Vidian neurectomy is effective in alleviating nasal symptoms, improving pulmonary function, and reducing the risk of AHR of patients with AR&CRSwNP by decreasing the level of ECP.
目前，变应性鼻炎和鼻息肉慢性鼻-鼻窦炎（AR&CRSwNP）患者手术干预对肺功能的影响尚不清楚。本研究旨在探讨翼管神经切断术对 AR&CRSwNP 患者肺功能和气道高反应性（AHR）的影响。
对 112 例 AR&CRSwNP 患者 AHR、支气管哮喘（BA）和肺功能损害的发生率进行了调查。随后，我们评估了翼管神经切断术的效果及其对肺功能和 AHR 的影响。此外，我们还探讨了术后嗜酸性阳离子蛋白（ECP）水平与肺功能指标变化或乙酰甲胆碱剂量之间的相关性。
本研究中，AR&CRSwNP 患者肺功能损害、支气管哮喘和 AHR 的发生率分别为 61.61%、69.64%和 66.96%。特别地，翼管神经切断术可有效缓解 AR&CRSwNP 患者的鼻部症状，改善肺功能，降低 AHR。此外，术后 ECP、IgE、白细胞介素-4 和白细胞介素-5 水平显著下降，ECP 水平与肺功能指标或乙酰甲胆碱剂量之间存在明显的负相关。
通过降低 ECP 水平，翼管神经切断术可有效缓解 AR&CRSwNP 患者的鼻部症状，改善肺功能，降低 AHR 风险。
