鼻中隔偏曲成形术联合低温等离子消融术治疗对AR患者T淋巴细胞亚群血清IL-5及OPN水平的影响

doi:10.3969/j.issn.1006-6233.2021.09.034

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摘要 目的: 探究鼻中隔偏曲成形术联合低温等离子消融术治疗对变应性鼻炎(AR)患者T淋巴细胞亚群、血清白细胞介素-5(IL-5)及骨桥蛋白(OPN)水平的影响。方法: 前瞻性选取2018年1月至2019年12月本院收治的90例AR患者作为研究对象,采用随机数字表法简单随机分为两组,对照组(45例)予以鼻中隔偏曲成形术治疗,观察组(45例)予以鼻中隔偏曲成形术联合低温等离子消融术治疗。比较两组患者疗效、术后并发症和鼻腔黏膜完整情况,以及治疗前后AR患者T淋巴细胞亚群(CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺)、血清IL-5及OPN水平变化。结果: 观察组治疗总有效率为95.56%,高于对照组的82.22%,差异有统计学意义(P<0.05)。重复测量方差分析显示时点效应可显著影响CD4⁺、CD8⁺、CD4⁺/CD8⁺水平的变化(P<0.05),时点和组间的交互效应均可以显著CD4⁺、CD4⁺/CD8⁺水平的变化(P<0.05),观察组治疗后CD4⁺、CD4⁺/CD8⁺较治疗前的下降幅度大于对照组,差异有统计学意义(t=2.322、2.970,均P<0.05);组间效应对CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺水平影响不明显(P>0.05)。重复测量方差分析显示时点效应、组间效应及时点和组间的交互效应均可显著影响IL-5、OPN水平的变化(P<0.05),观察组治疗后IL-5、OPN较治疗前的下降幅度大于对照组,差异有统计学意义(t=12.032、6.301,均P<0.05)。重复测量方差分析显示时点效应可显著影响CD4⁺、CD8⁺、CD4⁺/CD8⁺水平的变化(P<0.05),时点和组间的交互效应均可以显著CD4⁺、CD4⁺/CD8⁺水平的变化(P<0.05);且观察组治疗后CD4⁺、CD4⁺/CD8⁺水平降低程度较对照组明显,差异有统计学意义(均P<0.05)。重复测量方差分析显示时点效应、组间效应及时点和组间的交互效应均可显著影响IL-5、OPN水平的变化(P<0.05);且观察组治疗后IL-5、OPN水平降低程度较对照组明显,差异有统计学意义(均P<0.05)。观察组和对照组并发症发生率就黏膜完整率比较,差异无统计学意义(P>0.05)。结论: 鼻中隔偏曲成形术联合低温等离子消融术治疗AR疗效显著,安全性高,且能明显改善T淋巴细胞亚群水平,降低血清IL-5、OPN水平。

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	周莉
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关键词 ：鼻中隔偏曲成形术, 低温等离子消融术, 变应性鼻炎, T淋巴细胞亚群, 白细胞介素-5, 骨桥蛋白

Abstract：Objective: To explore the effect of nasal septal deflection plasty combined with low-temperature plasma ablation on T lymphocyte subsets, serum interleukin-5 (IL-5) and osteopontin (OPN) levels in patients with allergic rhinitis (AR). Methods: 90 patients with AR admitted to our hospital from January 2018 to December 2019 were prospectively selected and randomly divided into two groups by random number table. The control group (45 cases) was treated with nasal septum deviation plasty, and the observation group (45 cases) was treated with nasal septum deviation plasty combined with low temperature plasma ablation. The curative effect, postoperative complications, nasal mucosa integrity, T lymphocyte subsets (CD3⁺, CD4⁺, CD8⁺, CD4⁺ / CD8⁺), serum IL-5 and OPN levels of AR patients before and after treatment were compared between the two groups. Results: The total effective rate of treatment in the observation group was 95.56%, which was higher than 82.22% in the control group. The difference was statistically significant (P<0.05). Repeated measures analysis of variance showed that time-point effects can significantly affect the changes in CD4⁺, CD8⁺, CD4⁺ /CD8⁺ levels (P<0.05), and the interaction effects between time-points and groups can significantly change the levels of CD4⁺, CD4⁺ /CD8⁺ (P<0.05) ), the reduction of CD4⁺ and CD4⁺/CD8⁺ in the observation group after treatment was greater than that before the treatment, and the difference was statistically significant (t=2.322, 2.970, all P<0.05); the effect between groups affects the levels of CD3⁺, CD4⁺, CD8⁺, CD4⁺ /CD8⁺ Not obvious (P>0.05). Repeated measures analysis of variance showed that time-point effects, inter-group effects, time-points, and inter-group interaction effects can significantly affect the changes in IL-5 and OPN levels (P<0.05). The decrease of IL-5 and OPN in the observation group after treatment was greater than that before treatment, and the difference was statistically significant (t=12.032, 6.301, all P<0.05). There was no significant difference in the incidence of complications between the observation group and the control group in terms of the mucosal integrity rate (P>0.05). Conclusion: The nasal septum deflection plasty combined with low-temperature plasma ablation has a significant curative effect and high safety in the treatment of AR, and can significantly improve the level of T lymphocyte subsets and reduce the serum IL-5 and OPN levels.

Key words： Rhinoplasty Low-temperature plasma ablation Allergic rhinitis T lymphocyte subsets Interleukin-5 Osteopontin

基金资助:安徽省转化医学研究院科研基金项目,(编号:2018zhyx17)

引用本文:

周莉, 李雯, 顾怀宇. 鼻中隔偏曲成形术联合低温等离子消融术治疗对AR患者T淋巴细胞亚群血清IL-5及OPN水平的影响[J]. 河北医学, 2021, 27(9): 1557-1561.
ZHOU Li, LI Wen, GU Huaiyu. Effect of Nasal Septum Deflection Plastic Surgery Combined with Low-temperature Plasma Ablation on T Lymphocyte Subsets Serum IL-5 and OPN Levels in Patients with AR. HeBei Med, 2021, 27(9): 1557-1561.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2021.09.034 或 http://www.hbyxzzs.cn/CN/Y2021/V27/I9/1557

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