肖文东

DOI：10.16662/j.cnki.1674-0742.2017.16.125

[摘要] 目的 探討两性霉素B联合内镜手术对真菌性鼻-鼻窦炎患者炎症反应及免疫功能的影响。方法 便利选择了该院2010年3月—2016年3月收治的真菌性鼻-鼻窦炎患者100例为观察组，再选择同期于该院身体检查健康者100例为对照组；观察组选择两性霉素B联合内镜手术治疗，对照组不给予治疗；比较两组患者的血清炎症指标及免疫功能情况。结果 观察组患者术后各项炎症指标均低于术前，差异有统计学意义（P<0.05）；观察组患者IL-4（153.1±41.9）pg/mL、IL-12（3.6±0.4）ng/mL、超敏C反应蛋白（3.8±2.4）mg/L均优于对照组IL-4（104.8±19.3）pg/mL、IL-12（3.2±0.3）ng/mL、超敏C反应蛋白（2.1±0.4）mg/L，差异有统计学意义（P<0.05）；两组IL-6（139.5±30.7）mg/L、IL-17（1.8±0.4）pg/mL、脂蛋白（253.2±125.8）mg/L与对照组IL-6（132.8±21.3）mg/L、IL-17（1.5±0.3）pg/mL、脂蛋白（213.5±105.3）mg/L差异无统计学意义（P>0.05）；观察组患者经治疗后的淋巴细胞总数、CD3+、CD4+、CD8+、IgG优于术前，但均低于对照组，差异有统计学意义（P<0.05）。结论 选择两性霉素B联合内镜手术治疗真菌性鼻-鼻窦炎患者，可充分改善患有此症患者的炎性反应与免疫功能。

[关键词] 两性霉素B；内镜；真菌性鼻-鼻窦炎；炎症反应；免疫功能

[中图分类号] R765 [文献标识码] A [文章编号] 1674-0742（2017）06（a）-0125-03

Effect of Amphotericin B and Endoscopic Surgery on the Inflammatory Reactions and Immune Function of Patients with Allergic Fungal Rhinosinusitis

XIAO Wen-dong

Otolaryngological department， Quanzhou Quangang District Hospital， Quanzhou， Fujian Province， 362801 China

[Abstract] Objective To discuss the effect of amphotericin B and endoscopic surgery on the inflammatory reactions and immune function of patients with allergic fungal rhinosinusitis. Methods 100 cases of patients from March 2010 to March 2016 with allergic fungal rhinosinusitis admitted and treated in our hospital were convenient selected as the observation group， and 100 cases of healthy persons with physical examination in our hospital at the same period were selected as the control group， and the observation group were treated with amphotericin B and endoscopic surgery， while the control group did not adopt the treatment， and the serum inflammatory index and immune function situation were compared between the two groups. Results The inflammatory indexes after operation were lower than those before operation in the observation group， and the difference was statistically significant（P<0.05）， and the IL-4， IL-12 and high-sensitivity c-reactive protein in the observation group were better than those in the control group， [（153.1±41.9）pg/mL， （3.6±0.4）ng/mL， （3.8±2.4）mg/L vs （104.8±19.3）pg/mL， （3.2±0.3）ng/mL，（2.1±0.4）mg/L]， and the differences were statistically significant（P<0.05）， and the differences in the IL-6， IL-17 and lipoprotein between the observation group and the control group were not statistically significant，[（139.5±30.7）mg/L， （1.8±0.4）pg/mL， （253.2±125.8）mg/L vs （132.8±21.3）mg/L， （1.5±0.3）pg/mL， （213.5±105.3）mg/L]（P>0.05）， after treatment， the sum total of lymphocytes， CD3+，CD4+，CD8+，IgG in the observation group were better than those before operation， but were lower than those in the control group， and the differences were statistically significant（P<0.05）. Conclusion The amphotericin B and endoscopic surgery in treatment of patients with allergic fungal rhinosinusitis can fully improve the inflammatory reactions and immune function of these patients.endprint

[Key words] Amphotericin B； Endoscopic； Allergic fungal rhinosinusitis； Inflammatory reaction； Immune function

鼻竇炎是真菌感染引起，还会侵犯鼻腔，严重影响患者生活质量。在治疗中，药物治疗是首选治疗方法，临床经验显示药物治疗方法虽然有一定效果，但是真菌性鼻窦炎易复发，而且复发率有上升趋势[1]，不少研究认为应联合手术治疗，内镜手术治疗因为自身优点得到广泛使用[2]。为分析两性霉素B联合内镜手术对真菌性鼻-鼻窦炎治疗效果，以该院2010年3月—2016年3月收治的真菌性鼻-鼻窦炎患者为研究对象开展研究，分析两性霉素B联合内镜手术疗效以及对免疫的影响，现报道如下。

1 资料与方法

1.1 一般资料

此次实验方便选择了该院收治的真菌性鼻-鼻窦炎患者100例为观察组，同期于该院身体检查健康者100例为对照组。经临床诊断后均确诊为真菌性鼻-鼻窦炎；……