论文部分内容阅读
目的：观察两性霉素B联合内镜手术对真菌性鼻－鼻窦炎（ FRS）患者炎症反应及免疫功能的影响。方法入选104例进行两性霉素B联合内镜手术治疗的FRS患者为试验组，并随机选取104例健康志愿者为对照组。试验组予以4μg· mL－1两性霉素B冲洗鼻腔，每天1次，持续4周。对照组不进行手术或治疗处理。观察试验组的临床疗效，以及术前、术后与对照组的血清白细胞介素－4（ IL－4）、IL－6、IL－12、IL－17、脂蛋白a、超敏C反应蛋白、淋巴细胞总数、CD3＋、CD4＋、CD8＋、CD19＋、免疫球蛋白G（ IgG）、IgM的水平。结果术后，试验组达到治愈者96例（92.31％），有效者8例（7.69％）。术前，试验组的血清IL－4、IL－6、IL－12、IL－17、脂蛋白a、超敏C反应蛋白等指标水平均明显高于对照组（ P＜0.01）；术后，试验组的IL－4、IL－12、超敏C反应蛋白明显高于对照组（ P＜0.01）， IL－6、IL －17、脂蛋白 a 与对照组比较差异无统计学意义（ P＞0.05）。术前，试验组的淋巴细胞总数、CD3＋、CD4＋、CD8＋、IgG等均显著低于对照组（P＜0.01）；术后，试验组的上述指标较术前均明显提高（P＜0.01），但仍然显著低于对照组（ P＜0.01）。2组的CD19＋、IgM指标比较差异无统计学意义（ P＞0.05）。结论两性霉素B联合内镜手术有助于改善FRS患者的炎性反应和免疫功能。“,”Objective To investigate the effect of amphotericin B com-bined with endoscopic surgery on inflammatory response and immune function in patients with fungal rhinosinusitis ( FRS ).Methods One hundred and four cases of patients with FRS treated with amphotericin B combined with endoscopic surgery were selected as treatment group.And 104 cases of healthy volunteers were randomly selected as control group.Patients in treatment group were treated with 4μg· mL-1 amphotericin B for nasal wash , once every day for 4 weeks.Patients in control group received no surgery or treatment.In treatment group before and after surgery , serum interleukin 4 ( IL -4 ) , IL -6 , IL -12 , IL -17 , lipoprotein ( a ) [ Lp ( a ) ] , high -sensitivity C -reactive protein ( hs-CRP) , total lymphocyte count , CD3 +, CD4 +, CD8 +, CD19 +, immunoglobulin G ( IgG) and IgM levels were detected.Results After surgery , 96 cases in treatment group achieved cure ( 92.31%) , 8 cases had no effect ( 7.69%).In treatment group before surgery , serumIL-4, IL -6, IL -12,IL -17,Lp (a), hs -CRP levels were significantly higher than those in control group ( P<0.01 ).After surgery , IL-4 , IL-12 and hs -CRP in treatment group were significantly higher than those in control group ( P 0.05 ) .Before surgery , total lymphocyte count , CD3 +, CD4 +, CD8 +and IgG in treatment group were signifi-cantly lower than those in control group , while theses indexes significantly increased after surgery ( P<0.01 ) , but significantly lower than that in control group ( P0.05 ).Conclusion Amphotericin B combined with endoscopic surgery helped to improve inflammatory response and immune function in patients with FRS .