The effect of slow-release glucocorticoid stent on nasal mucosal eosinophil and nasal microbiota in patients with eosinophilic chronic sinusitis and nasal polyps
The effect of slow-release glucocorticoid stent on nasal mucosal eosinophil and nasal microbiota in patients with eosinophilic chronic sinusitis and nasal polyps
冯世斌 1徐克素 1刘荣松 1赵存尧 1周春桃1
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作者信息
1. 黔江中心医院,重庆 400900
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摘要
目的 研究缓释糖皮质激素支架对嗜酸粒细胞型慢性鼻窦炎伴鼻息肉(eosinophilic chronic rhinosinusitis with nasal polyps,ECRSwNP)手术患者鼻黏膜嗜酸粒细胞(Eos)浸润与鼻腔菌群的影响.方法 选取2020年8月～2022年8月黔江中心医院收治的104例ECRSwNP患者,采用随机数字表法将患者分为观察组与对照组各52例,鼻内镜手术中分别植入或未植入缓释糖皮质激素支架,比较两组住院时间、鼻腔恢复通气时间及治疗总有效率,比较两组术前和术后1个月的鼻黏膜Eos%及鼻腔菌群,比较两组术前和术后3个月的鼻内镜Lund-Kennedy评分、鼻腔鼻窦结局测试22条(SNOT-22)及视觉模拟量表(VAS)评分,比较两组术后3个月的干预率及额窦口通畅率.结果 观察组住院时间、鼻腔恢复通气时间均显著低于对照组(P<0.05).观察组治疗总有效率为92.31%(48/52)显著高于对照组76.92%(40/52)(P<0.05).术后两组鼻黏膜Eos%较术前显著降低(P<0.05),且观察组低于对照组(P<0.05).术前两组Shannon指数、Chaol指数无统计学意义(P>0.05);对照组术后Shannon指数较术前显著降低(P<0.05),术后Chaol指数较术前显著增高(P<0.05);观察组术后Shannon指数、Chaol指数较术前无显著差异(P>0.05).术后两组Lund-Kennedy评分、SNOT-22评分及VAS评分较术前均显著降低(P均<0.05),且观察组低于对照组(P<0.05).观察组患者干预率显著低于对照组(P<0.05),额窦口通畅率显著高于对照组(P<0.05).结论 缓释糖皮质激素支架有利于ECRSwNP手术患者术腔上皮化,可减少黏膜Eos%,改善临床症状,保证额窦引流通畅,降低术后干预率,对鼻腔菌群无显著影响.
Abstract
OBJECTIVE To investigate the effect of sustained-release glucocorticoid stent on nasal mucosal eosinophil(Eos)%and nasal microbiota in patients undergoing eosinophilic chronic sinusitis with nasal polyps(ECRSwNP)surgery.METHODS A total of 104 patients with ECRSwNP admitted to Qianjiang Central Hospital from August 2020 to August 2022 were selected.The patients were randomly divided into an observation group and a control group,with 52 patients in each group.During nasal endoscopic surgery,slow-release glucocorticoid stents were implanted or not.The hospital stay,nasal ventilation recovery time,and total effective rate of treatment were compared between the two groups.The nasal mucosal Eos%and nasal microbiota were compared between the two groups before and one month after surgery.The Lund-Kennedy score of nasal endoscopy,SNOT-22 outcome tests,and visual analogue scale(VAS)scores were compared between the two groups before and three months after surgery.The intervention rate and frontal sinus patency rate at 3 months after surgery in two groups.RESULTS The hospitalization time and nasal ventilation recovery time of the observation group were significantly lower than those of the control group(P<0.05).The total effective rate of the observation group treatment was 92.31%(48/52),which was significantly higher than that of the control group 76.92%(40/52)(P<0.05).After surgery,the Eos%of the nasal mucosa in both groups significantly decreased compared to before surgery(P<0.05),and the observation group was lower than the control group(P<0.05).There was no statistically significant difference in Shannon index and Chaol index between the two groups before surgery(P>0.05);The Shannon index in the control group decreased significantly after surgery(P<0.05),while the Chaol index increased significantly after surgery(P<0.05);There was no significant difference in postoperative Shannon index and Chaol index between the observation group and preoperative group(P>0.05).After surgery,the Lund-Kennedy score,SNOT-22 score,and VAS score in both groups were significantly lower than before(P<0.05),and the observation group was lower than the control group(P<0.05).The intervention rate of the observation group was significantly lower than that of the control group(P<0.05),and the frontal sinus patency rate was significantly higher than that of the control group(P<0.05).CONCLUSION The sustained-release glucocorticoid stent is beneficial for the epithelialization of the surgical cavity in ECRSwNP patients,reducing mucosal Eos%,improving clinical symptoms,ensuring smooth frontal sinus drainage,reducing postoperative intervention rates,and having no significant impact on nasal microbiota.
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