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克拉霉素联合丙酸氟替卡松对慢性鼻-鼻窦炎患者功能性鼻内镜鼻窦手术后鼻功能、鼻黏膜纤毛传输功能及血清炎症标志物的疗效

Efficacy of Clarithromycin Combined with Fluticasone Propionate on Nasal Function, Nasal Mucociliary Transport Function, and Serum Inflammatory Markers in Chronic Rhinosinusitis Patients After Functional Endoscopic Sinus Surgery.

作者信息

Wu Yuhua, Shi Xuezheng, Ni Shuren, Sun Hao

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, Shunyi Maternal and Children's Hospital of Beijing Children's Hospital, Beijing, China.

出版信息

Ear Nose Throat J. 2024 Nov 2:1455613241294244. doi: 10.1177/01455613241294244.

Abstract

This study aims to assess the efficacy of clarithromycin (CAM) combined with fluticasone propionate (FP) in patients with chronic rhinosinusitis (CRS) after functional endoscopic sinus surgery (FESS), focusing on nasal function, nasal mucociliary transport (MCT) function, and serum inflammatory markers. The control group (n = 48) was treated with FESS alone, while the study group (n = 48) was treated with FESS plus CAM combined with FP. The clinical effects, symptom scores, nasal function, nasal MCT function, serum inflammatory marker levels, and the occurrence of adverse reactions were compared. The total efficacy rate of the study group (95.83%) was significantly higher than that of the control group (83.33%). After treatment, the study group showed lower symptom scores for nasal congestion, runny nose, sneezing and dizziness, and headache compared to those in the control group. The study group also had lower nasal airway resistance, shorter distance from the minimal cross-sectional area to the nostril, and lower T&T olfactory scores. In contrast, their nasal cavity volume and minimal cross-sectional area were higher than those of the control group. Additionally, the nasal mucociliary clearance and MCT rates were higher in the study group. Serum levels of interleukin-6, interleukin-8, tumor necrosis factor-α, and procalcitonin were significantly lower in the study group compared to the control group (all < .05). The use of CAM combined with FP in patients after FESS for CRS is effective, leading to the relief of clinical symptoms, improvement of nasal function, enhancement of MCT function, and reduction of inflammatory response, without increasing the incidence of adverse reactions.

摘要

本研究旨在评估克拉霉素(CAM)联合丙酸氟替卡松(FP)对慢性鼻-鼻窦炎(CRS)患者功能性鼻内镜鼻窦手术(FESS)后疗效的影响,重点关注鼻功能、鼻黏液纤毛运输(MCT)功能及血清炎症标志物。对照组(n = 48)仅接受FESS治疗,而研究组(n = 48)接受FESS联合CAM与FP治疗。比较两组的临床疗效、症状评分、鼻功能、鼻MCT功能、血清炎症标志物水平及不良反应发生情况。研究组总有效率(95.83%)显著高于对照组(83.33%)。治疗后,研究组鼻塞、流涕、打喷嚏、头晕及头痛的症状评分低于对照组。研究组鼻气道阻力更低,最小横截面积至鼻孔的距离更短,T&T嗅觉评分更低。相比之下,其鼻腔容积和最小横截面积高于对照组。此外,研究组鼻黏液纤毛清除率和MCT速率更高。研究组血清白细胞介素-6、白细胞介素-8、肿瘤坏死因子-α及降钙素原水平显著低于对照组(均P < 0.05)。CRS患者FESS术后使用CAM联合FP有效,可缓解临床症状、改善鼻功能、增强MCT功能并减轻炎症反应,且不增加不良反应发生率。

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