枸地氯雷他定联合鼻窦内窥镜手术治疗慢性鼻窦炎疗效及对患者血清TIgE、ECP和炎性因子的影响

Curative efficacy of Desloratadine Citrate Disodium in combination with endoscopic sinus surgery and its effects on serum TIgE, ECP and inflammatory factors in patients with chronic sinusitis

摘要:

目的??观察分析枸地氯雷他定联合鼻窦内窥镜手术治疗慢性鼻窦炎疗效及对患者血清总免疫球蛋白E（TIgE）、嗜酸性粒细胞阳离子蛋白（ECP）和炎性因子的影响。方法?收集2015年1月-2016年6月于该院接受治疗的90例慢性鼻窦炎患者作为研究对象，随机分为对照组45例和观察组45例。对照组患者给予鼻窦内窥镜手术治疗，观察组在对照组基础上联合枸地氯雷他定治疗。采用视觉模拟评分（VAS）评价患者主观症状严重程度。术后3个月，比较两组患者临床疗效、VAS评分、血清TIgE、ECP及炎性因子水平。结果?所有患者均成功完成手术。慢性鼻窦炎临床疗效显示，观察组患者治疗总有效率明显高于对照组（95.6% vs 82.2%，P <0.05）。治疗后，与对照组相比，观察组流涕、鼻塞、面颊部疼痛、头痛和嗅觉减退等症状的VAS评分降低，评分分别为（1.84±0.89）vs（3.12±1.03）、（1.87±0.81）vs（2.55±1.14）、（1.24±0.86）vs（1.88±0.79）、（1.15±0.54）vs（1.97±0.83）和（1.84±0.73）vs（2.18±0.84）分，血清TIgE、ECP水平降低，分别为（58.62±7.36）vs（64.39±7.18）kU/L和（4.25±0.84）vs（5.01±1.07）ng/L，肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）和白细胞介素-8（IL-8）等炎性因子水平降低，分别为（1.27±0.46）vs（2.62±0.53）ng/ml、（5.13±1.24）vs（9.54±2.23）pg/ml和（282.63±32.42）vs（315.84±35.89）ng/L，组间比较差异均有统计学意义（均P <0.05）。结论?枸地氯雷他定联合鼻窦内窥镜手术治疗慢性鼻窦炎疗效良好，能够明显缓解临床症状，降低血清TIgE、ECP水平，减轻炎性反应，临床上值得进一步研究。

Abstract:

Objective?To observe and analyze curative efficacy of Desloratadine Citrate Disodium in combination with endoscopic sinus surgery and its effects on serum TIgE, ECP and inflammatory factors in patients with chronic sinusitis.?Methods?90 patients with chronic sinusitis who received therapy in our hospital from January 2015 to June 2016 were collected as research objects to be randomly divided into the control group and the observation group equally. The control group was given endoscopic sinus surgery, and the observation group was given Desloratadine Citrate Disodium in combination with endoscopic sinus surgery. Then, visual analogue scale (VAS) was applied to assess the severity of subjective symptoms of the disease. Three months after the surgery, the curative efficacy, scores of visual analogue scale (VAS) reflecting clinical symptoms, levels of serum TIgE, ECP and inflammatory factors were compared between the two groups.?Results?All patients undergone successful surgery. The observation group had a total therapeutic efficiency ratio of 95.6%, which was significantly higher than that of 82.2% in the control group (P < 0.05). In comparison with the control group, the observation group had lower VAS scores of nasal discharge, nasal obstruction, cheek pain, headache, hyposmia [(1.84 ± 0.89) vs (3.12 ± 1.03) points, (1.87 ± 0.81) vs (2.55 ± 1.14) points, (1.24 ± 0.86) vs (1.88 ± 0.79) points, (1.15 ± 0.54) vs (1.97 ± 0.83) points, (1.84 ± 0.73) vs (2.18 ± 0.84) points], lower levels of serum TIgE, ECP [(58.62 ± 7.36) vs (64.39 ± 7.18) kU/L, (4.25 ± 0.84) vs (5.01 ± 1.07) ng/L)] and inflammatory factors of TNF-α, IL-6, IL-8 [(1.27 ± 0.46) vs (2.62 ± 0.53) ng/ml, (5.13 ± 1.24) vs (9.54 ± 2.23) pg/ml, (282.63 ± 32.42) vs (315.84 ± 35.89) ng/L)] with statistical differences (all P < 0.05).?Conclusion?Desloratadine Citrate Disodium in combination with endoscopic sinus surgery is effective for chronic sinusitis, which can significantly relieve clinical symptoms, reduce levels of serum TIgE, ECP and alleviate inflammatory reaction.