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目的:评价鼻窦功能性手术(FESS)治疗慢性鼻窦炎合并支气管哮喘的远期疗效。方法:选择自2011年1月至2013年1月我院收治的慢性鼻窦炎患者65例,行FESS治疗。根据是否合并患有支气管哮喘将患者分为观察组(慢性鼻窦炎合并支气管哮喘)和对照组(慢性鼻窦炎),选择同期健康志愿者作为正常组。采用酶联免疫吸附测定测定白细胞介素4(IL-4)、干扰素-γ(IFN-γ)水平、可溶性白细胞介素2受体(sIL-2R)和可溶性Ig E低亲和力受体(sCD23)的水平,并术后随访2年观察对比慢性鼻窦炎和支气管哮喘改善情况。结果:对照组和观察组患者手术后的IL-4、sIL-2R及sCD23水平降低,IFN-γ水平升高,且与手术前的差异均有统计学意义(P<0.05);两组患者术后2年的慢性鼻窦炎治愈率均高于术后1年;观察组患者术后1年和术后2年的哮喘完全控制率明显高于术前,且差异具有统计学意义(P<0.05),且术后2年哮喘完全控制率显著高于术后1年之间(P<0.05);观察组患者术后1年、2年哮喘平均发作率显著低于术前,且术后2年的哮喘平均发作率明显低于术后1年(P<0.05)。结论:FESS用于治疗慢性鼻窦炎合并支气管哮喘具有良好的临床疗效,能够显著改善患者的IL-4、IFN-γ、sIL-2R及sCD23水平,且随着时间的延长,其远期疗效较满意。
Objective: To evaluate the long-term efficacy of sinus surgery (FESS) in the treatment of chronic sinusitis complicated with bronchial asthma. Methods: From January 2011 to January 2013 in our hospital admitted to patients with chronic sinusitis in 65 patients underwent FESS treatment. Patients were divided into the observation group (chronic sinusitis with bronchial asthma) and the control group (chronic sinusitis) according to whether they had bronchial asthma or not, and healthy volunteers of the same period were selected as the normal group. The levels of IL-4, IFN-γ, soluble interleukin 2 receptor (sIL-2R) and soluble IgE low affinity receptor (sCD23 ) Levels were observed and followed up for 2 years to compare the improvement of chronic sinusitis and bronchial asthma. Results: The levels of IL-4, sIL-2R and sCD23 decreased and the level of IFN-γ increased in the control group and the observation group after operation. The difference between the two groups was statistically significant (P <0.05) The cure rate of chronic sinusitis after 2 years was higher than that of 1 year after operation. The complete control rate of asthma at 1 year and 2 years after operation in the observation group was significantly higher than that before operation, and the difference was statistically significant (P < 0.05). The complete control rate of asthma at 2 years after operation was significantly higher than that at 1 year after operation (P <0.05). The average incidence of asthma at 1 year and 2 years after operation in the observation group was significantly lower than that before operation The average incidence of asthma in 2 years was significantly lower than that of 1 year after operation (P <0.05). CONCLUSIONS: FESS has good clinical efficacy in the treatment of chronic sinusitis with bronchial asthma, and can significantly improve the levels of IL-4, IFN-γ, sIL-2R and sCD23 in patients with chronic sinusitis, and its long-term efficacy over time satisfaction.