Effect of clarithromycin combined with endoscopic sinus surgery on inflammation and immune function in patients with chronic sinusitis and nasal polyps
Objective:To investigate the effect of clarithromycin combined with endoscopic sinus surgery on inflammatory response and immune function in patients with chronic sinusitis and nasal polyps.Methods:A total of 160 patients with chronic sinusitis and nasal polyps who received treatment at the Affiliated Hospital of Qinghai University from January 2018 to December 2020 were selected. Of the patients, there were 98 males and 62 females with a mean age of (45.4±7.9) years (range, 27-66 years). All of them were treated with clarithromycin combined with endoscopic sinus surgery. The efficacy was evaluated by nasal endoscopy and clinical symptoms 3 months after the operation. The results of nasal endoscopic examination and quantitative sinus CT examination before and 3 months after operation were compared. Visual analog scale (VAS) was used to evaluate subjective symptoms. Quality of life was assessed using the nasal sinus outcome test (SNOT)-20 scale. Serum levels of interleukin (IL)-17, IL-23, tumor necrosis factor-α (TNF-α), CD3+ T cells, CD4+ T cells, and CD4+/CD8+ ratio were measured before and 3 months after the surgery.Results:Of the 160 patients with chronic sinusitis and nasal polyps included, 143 were cured and 170 had improvement of the symptoms, with a total effective rate of 100%. The Lund-Kennedy score (2.9±0.6) and Lund-Mackay score (3.0±0.7) at 3 months after surgery were lower than those before surgery (13.7±3.2 and 8.5±1.3, respectively) (t=42.243 and 44.448, respectively, P＜0.001 for both). The VAS score and SNOT-20 score at 3 months after surgery were both significantly lower than those before surgery (2.2±0.5 vs 6.5±1.2 and 12.3±3.4 vs 21.9±5.2, t=41.269 and 19.515, respectively, P＜0.001 for both). Serum IL-17, IL-23, and TNF-α at 3 months after operation were all significantly lower than those before operation (t=25.440, 29.337, and 25.953, respectively, P＜0.001 for all). Three months after operation, the percentages of CD3+ T cells and CD4+ T cells and CD4+/CD8+ ratio were significantly higher than those before operation (62.3%±3.1% vs 56.3%±3.5%, 41.5%±3.7% vs 35.7%±2.9%, and 1.7±0.3 vs 1.3±0.2, t=16.223, 13.981, and 12.490, respectively, P＜0.001 for all).Conclusion:Clarithromycin combined with endoscopic sinus surgery has significant clinical effects in patients with chronic sinusitis and nasal polyps, and can significantly reduce symptoms and inflammatory reactions and exert an influence on the systemic immune status of patients.
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