重度阻塞性睡眠呼吸暂停低通气综合征患者鼻通气状态的客观评估

目的:应用鼻声反射和鼻阻力测量对重度阻塞性睡眠呼吸暂停低通气综合征(sOSAHS)患者的鼻腔状况进行客观评估。方法:39例正常成年男性为A组,65例sOSAHS患者分为B组(BMI<28)和C组(BMI≥28)。分别测量单侧鼻腔第1狭窄面积、单侧鼻腔第2狭窄面积、单侧鼻腔最小截面积、单侧0～5cm、2～5cm鼻腔容积、单侧吸气阻力、单侧呼气阻力及鼻气道总阻力(TRins、TRexp),将各组间参数进行比较,并与PSG结果进行相关性分析。结果:B组的鼻阻力值明显高于其他2组(P<0.05),其余各参数组间差异无统计学意义(均P>0.05)。B组的TRins、TRexp均与呼吸暂停低通气指数呈正相关(r=0.402、0.401,均P<0.05)。结论:鼻阻力增高可能是非肥胖sOSAHS患者的发病因素之一。     

阻塞性睡眠呼吸暂停综合征与不同体位下鼻阻力的关系

目的 :探讨不同体位下鼻阻力的变化及其与阻塞性睡眠呼吸暂停综合征 (OSAS)的关系。方法 :对 14例正常人、2 0例单纯鼾症和 4 0例OSAS患者进行坐位和仰卧位的鼻阻力检测 ,并行多导睡眠呼吸监测。将单纯鼾症和OSAS患者按有无鼻腔疾病分成阴性组和阳性组。结果 :①单纯鼾症鼻阴性组以及OSAS鼻阴性组的鼻阻力明显高于正常组 (P <0 .0 5 )。②OSAS鼻阳性组坐位与卧位鼻阻力明显高于单纯鼾症鼻阳性组 (P <0 .0 5 )。③各分组卧位的鼻阻力高于坐位(P <0 .0 5 ) ,OSAS鼻阴性组和阳性组之间差异有极显著性意义 (P <0 .0 1)。④OSAS患者中 ,鼻阳性组呼吸暂停和低通气指数、觉醒指数、鼾声指数高于鼻阴性组 ,最低血氧饱和度低于鼻阴性组 (P <0 .0 5 )。结论 :单纯鼾症与OSAS患者鼻阻力都较正常人增加 ,且仰卧位时较坐位时明显增加 ;鼻阻力可能与OSAS发病有关     

血管运动性鼻炎患者鼻通气功能的评估

目的 检测血管运动性鼻炎患者的鼻通气功能,分析其与主观症状的相关性,并与健康对照组进行比较.方法 选择血管运动性鼻炎患者105例,健康对照组成人71例.采用鼻阻力测量获得压力-流速曲线,进而得到75 Pa和150 Pa下鼻腔总阻力值.采用鼻声反射测量应用鼻用缩血管药物前后的面积-距离曲线,进而得到鼻腔最小横截面积,计算鼻腔充血指数.对比两组研究对象各项鼻阻力和鼻声反射测量指标,分析血管运动性鼻炎患者主观症状评分与鼻通气功能指标间的相关性.采用SPSS 16.0软件进行统计分析.结果 血管运动性鼻炎患者鼻阻力、鼻声反射指标与各种鼻部症状间的相关性分析均无统计学意义(P值均>0.05).收缩前后的鼻腔最小横截面积在两组间差异未见统计学意义(Z值分别为-1.541、-0.626,P值均>0.05);鼻腔充血指数在两组间差异有统计学意义(Z=-2.707,P<0.05).75 Pa下鼻总阻力值在两组间差异有统计学意义(Z=-4.334,P<0.05);150 Pa下鼻总阻力值在两组间差异无统计学意义(Z=-1.314,P>0.05).结论 血管运动性鼻炎患者主观症状与客观鼻生理功能检测结果 间无相关性,在诊疗过程中需全面综合评价患者的主观症状和客观检测结果 .     

鼻阻塞的主观评价与客观鼻测量的相关性研究

目的 探讨鼻阻塞时检查者和患者的主观评价与客观鼻测量之间是否有相关性.方法 检查者和患者均采用视觉模拟量表(visual analog scale,VAS)对鼻阻塞程度进行评价.客观鼻测量采用主动后鼻测压仪和鼻声反射测量仪进行.以配对t检验分析检查者的临床评价和患者VAS均数的差异,以Spearman等级相关分析评价客观鼻测量结果单侧鼻气流阻力与单侧鼻道容积、单侧鼻腔最小横截面积的关系,以及检查者的临床评价、患者VAS与上述客观鼻测最结果的相关性.结果 本组病例经统计学分析,316例患者中,减充血前后单侧鼻气流阻力与单侧鼻道容积、单侧鼻腔最小横截面积间呈负相关(r值分别为-0.430、-0.554、-0.373、-0.600,P值均＜0.001).减充血前后,检查者的临床评价与患者VAS均数呈正相关,差异均有统计学意义(r值分别为0.630、0.526,P值均＜0.001),二者均与鼻气流阻力有一定的正相关关系(减充血前:检查者的临床评价与鼻气流阻力r=0.530,P=0.000,患者VAS与鼻气流阻力r=0.351,P=0.000;减充血后:检查者的临床评价与鼻气流阻力r=0.452,P=0.000,患者VAS与鼻气流阻力r=0.216,P=0.000),与鼻道容积和鼻腔最小横截面积均有一定的负相关关系(减充血前:检查者的临床评价与鼻道容积r=-0.411,P=0.000,患者VAS与鼻道容积r=-0.325,P=0.000,检查者的临床评价与鼻腔最小横截面积r=-0.507,P=0.000,患者VAS与鼻腔最小横截面积r=-0.384,P=0.000;减充血后:检查者的临床评价与鼻道容积r=-0.391,P=0.000,患者VAS与鼻道容积r=-0.209,P=0.000,检查者的临床评价与鼻腔最小横截面积r=-0.471,P=0.000,患者VAS与鼻腔最小横截面积r=-0.286,P=0.000).检查者的临床评价与客观鼻测量参数的相关系数大于患者VAS与客观鼻测最参数的相关系数.结论 鼻阻力测压与鼻声反射测量的结果有一定的相关性.检查者的临床评价与患者VAS存在一定的正相关关系.两者均与客观鼻测量参数存在一定的直线相关关系.     

山莨菪碱对豚鼠实验性鼻超敏反应的影响

目的 :观察山莨菪碱对豚鼠实验性鼻超敏反应的影响。方法 :将实验动物分为正常对照组 ,二异氰酸甲苯脂 (TDI)致敏组 ,利血平组和山茛菪碱组 ,以其鼻部症状记分及鼻粘膜细胞学的变化作为观察项目。结果 :利血平组鼻部症状较 TDI致敏组明显加重 ,鼻粘膜嗜酸性粒细胞明显增高 ,其差异有极显著性意义 (均 P <0 .0 1)。山莨菪碱组鼻部症状明显减轻 ,嗜酸性粒细胞数明显减少 ,与利血平组比较 ,差异有显著性意义 (均 P <0 .0 1)。结论 :以副交感神经兴奋为主的鼻超敏反应性疾病 ,经鼻给予山莨菪碱有一定治疗作用。     

正常成年人鼻通气状态的客观评估

目的:获得我国正常成年人大样本鼻声反射和鼻阻力测量结果的正常值范围,分析性别、年龄对其的影响,并对2种检查结果之间的相关性进行研究.方法:利用Eccovision鼻声反射仪测量正常成年人鼻腔的最小截面积(MCA),0～5 cm、2～5 cm、0～7 cm鼻腔容积(V5、V2～5、V7);利用ATMOS 300鼻阻力计通过前鼻主动测压法测量压差为75 Pa和150 Pa时的单侧及双侧鼻腔阻力(R75,R150,R75T,R150T).结果:MCA男性为(0.66士0.18)cm2,女性为(0.57±0.16)cm2;V5男性为(5.35±1.40)cm3,女性为(4.50±1.19)cm3;V2～5男性为(3.53±1.23)cm3,女性为(3.09±1.08)cm3,V7男性为(9.26±2.73)cm3,女性为(8.04±2.40)cm3,男女之间均差异有统计学意义.R75男性为(0.66±0.34)Pa·cm-3·s-1,女性为(0.77±0.33)Pa·cm-3·s-1;男女之间差异有统计学意义;R150.男性为(0.51±0.22)Pa·cm-3·s-1,女性为(0.58±0.22)Pa·cm-1·s-1,男女之间差异无统计学意义.R757T男性为(0.30±0.12)Pa·cm-3·s-1,女性为(0.39±0.14)Pa·cm-3·s-1,二者之间差异有统计学意义;R150T男性为(0.24±0.09)Pa·cm-3·s-1,女性为(0.29±0.09)Pa·cm-3·s-1,二者之间差异无统计学意义.MCA、V5、R75与年龄之间有显著的相关性;R150与年龄之间无显著的相关性.R75、R150与MCA、V7、V5、V2～5之间均有显著的相关性.结论:我国正常成年人的鼻声反射和鼻阻力的测量结果之间具有一定的相关性,鼻阻力、鼻腔容积及最小截面积存在着性别和年龄差异,但不同侧别之间差异无统计学意义.     

鼻瓣区对鼻主观通畅感与鼻阻力形成的影响：数值模拟鼻气流相关性研究

目的通过数值模拟研究正常鼻腔中鼻腔主观通畅感、鼻瓣区大小和气流动力学参数之间的相关关系, 探讨鼻瓣区对鼻主观通畅感和鼻腔气流的影响作用。方法 2023年1—8月于上海交通大学医学院附属第九人民医院耳鼻咽喉头颈外科门诊选取52名健康受试者, 其中男性31名, 女性21名, 平均年龄37.8岁。对受试者进行鼻主观通畅感视觉模拟量表(Visual Analog Scale, VAS)评分(双侧分别评分), 运用数值模拟分析计算静息吸气状态下气流的动力学参数, 通过统计学相关性矩阵分析这些主观和客观参数之间的相关程度。结果 VAS评分与单侧鼻瓣区截面积(r=-0.85, P<0.01)和单侧鼻内气流(r=-0.57, P<0.01)呈负相关, 与单侧下鼻甲前端鼻阻力(nasal resistance, NR)呈正相关(r=0.61, P<0.01)。单侧鼻瓣区横截面积为(0.85±0.35)cm²(xˉ±s, 后同), 与单侧鼻腔NR呈中等程度负相关(r=-0.50, P<0.01), 与单侧鼻气流量呈正相关(r=0.61, P<0.01)。...     

四相鼻阻力测量法评估健康成人鼻腔通气状况的初步研究

目的 研究四相鼻阻力测量(four-phase rhinomanometry)法对评估健康成人鼻腔通气状况的临床应用价值.方法 健康成人85名,采用四相鼻阻力计测量吸气、呼气及整个呼吸过程中的有效阻力(effective resistance in inspiration,expiration and total breathing process,分别简称为Reffin、Reffex、Refft),以及吸气和呼气过程的顶点阻力(vertex resistance in inspiration and expiration process,分别简称为Vrin、Vrex).同时,应用鼻声反射仪测量鼻腔的最小横截面积(minimum cross-sectional area of nasal cavity,MCA)和0～5 cm的鼻腔容积(nasal volume from 0-5 cm,V5).对四项鼻阻力和鼻声反射测量结果 进行相关性分析.结果 健康成人男性和女性Reffin(x-±s)分别为(1.28±1.02)Pa/(cm3·s)和(1.55±1.03)Pa/(cm3·s);Reffex(x-±s)分别为(1.43±1.07)Pa/(cm3·s)和(1.75±1.14)Pa/(cm3·s);Refft(x-±s)分别为(1.34±0.99)Pa/(cm3·s)和(1.62±1.03)Pa/(cm3·s);Vrin(x-±s)分别为(1.31±1.03)Pa/,(cm3·s)和(1.60±1.03 Pa/(cm3·s);Vrex(x-±s)分别为(1.46±1.04)Pa/(cm3·s)和(1.82±1.17)Pa/(cm3·s),男性和女性的各观察值比较差异均无统计学意义(r值分别为:0.661、-0.397、0.127、0.649、-0.684,P值均>0.05).Reffin,Reffex,Refft,Vrin和Vrex,与年龄、身高、体重、头围、体表面积、体重指数之间均无显著的相关性(P值均>0.05).Reffin,Reffex,Refft,Vrin,Vrex与MCA、V5之间均有显著的相关性(r值为-0.18～-0.20,P值均<0.05).结论 四相鼻阻力测量的结果 与鼻声反射的测量结果 相关性良好,可作为评估成人鼻腔通气功能的临床检测手段.     

结构性鼻炎患者鼻通气功能的主客观评估

目的对结构性鼻炎患者进行术前鼻通气的主客观评估,为手术提供临床依据。方法结构性鼻炎患者56例,收缩鼻腔前后分别进行鼻堵视觉模拟量表(visualanalogue scale,VAS)评分并分为两组:组1,30例,VAS评分>7;组2,26例,VAS评分<7。组3,正常对照组,24例,VAS评分=0。3组分别进行鼻声反射和鼻阻力测量。记录两侧鼻腔前2个最小截面积(minimum cross-sectional area of nasal cavity,MCA1)、MCA2及其距离前鼻孔距离(the distance between the nostril to minimumcross-sectional area,MD1)、MD2,并分别记算两侧的比值;测量距离前鼻孔5 cm、2～5 cm、5～7 cm的两侧鼻腔容积(nasal volume,V5)、V2-5、V5-7并分别记算两侧的比值;测量双侧鼻腔总阻力(nasal resistance total,RT),计算双侧鼻腔阻力差异比(Rlr)。取收缩鼻腔后数值进行统计学检验。结果 3组MCA1、MD1、MCA2、MD2和RT值均无统计学差异;3组间各比值,除MD1、V5-7差异无统计学意义外,其余比值差异均存在统计学意义;组1测量结果较组2或组3有明显差异,结构异常也更加明显。结论鼻堵严重程度与两侧鼻腔结构异常程度有一定关联;鼻堵VAS评分、鼻声反射和鼻阻力测量应作为结构性鼻炎术前评估的常规手段。     

鼻声反射应用于鼻塞患者鼻通气功能检查的评价

目的 :评估鼻声反射 (AR)在鼻塞患者鼻通气检查中的应用价值 ,并探讨其参数选择。方法 :对 36例因鼻病引起鼻塞的患者 (鼻病组 )及 2 0例无鼻病健康志愿者 (对照组 )进行AR测试 ,测算鼻腔平均截面积 (MNCA)、最小截面积 (MCA)、鼻腔容积 (NV)和鼻阻力 (NR) ,并进行统计学分析。结果 :对照组中 ,MNCA、MCA、NV、NR性别差异均无统计学意义 (P >0 .0 5 ) ,除NV(P <0 .0 5 )外侧别差异亦无统计学意义 (P >0 .0 5 ) ;鼻病组中鼻塞侧与非鼻塞侧各参数间差异无统计学意义 (P>0 .0 5 ) ;鼻病组中鼻塞侧与对照组比较 ,其中MCA和NR差异有统计学意义 (分别P <0 .0 1和P <0 .0 5 ) ;鼻病组中非鼻塞侧加对照组与鼻病组中鼻塞侧比较 ,其中MCA和NR差异有统计学意义 (分别P <0 .0 1和P <0 .0 5 )。结论 :AR对鼻通气状况有较客观的反映 ,其中MCA和NR对鼻塞状况的反映与患者的主观感受较为一致 ,可作为反映鼻通气状况的敏感指标。     

The association of subjective nasal patency with peak inspiratory nasal flow in a large healthy population

This study, performed on 303 healthy volunteers, tested the null hypothesis that normal subjects were unable to assess their nasal patency when compared with objective measurement using peak inspiratory nasal flow rate (PINFR). Subjective assessments were made on a categorical scale and PINFR was measured using an In-Check meter. Analysis of variance showed that the peak inspiratory nasal flow rate, when grouped by the subjective scores, was significantly different.     

Laterality and severity of nasal obstruction does not correlate between physicians and patients,nor among physicians

BackgroundNasal obstruction is a common patient complaint and has a variety of etiologies, and a specific anatomical abnormality can often be found within the nasal cavity on physical examination. In practice, this observed pathology does not always correlate with the laterality, severity, and exact intranasal site of the patients' perceived obstruction.ObjectivesWe seek to answer the following questions: 1) Does a physician's evaluation of nasal obstruction correlate with subjective patient complaints? 2) Is there reasonable correlation between physicians of similar training in the routine evaluation of nasal obstruction?MethodsFirst, we asked patients presenting to the otolaryngology clinic with a primary complaint of nasal obstruction to fill out a modified NOSE survey. Nasal endoscopy was performed on all subjects to assess all potential sites of obstruction. We then determined whether there is an association between patient complaints and findings on physical examination. Second, we determined if there is correlation between similarly trained physicians in their interpretation of a basic nasal examination. Otolaryngologists were shown a series of standardized videos of an endoscopic nasal examination that were recorded with a primary complaint of nasal obstruction. Findings were reported in an anonymous online survey focusing on laterality, severity, and specific site of perceived obstruction.ResultsA total of 38 patients were included in the first part of the study. The Cohen's kappa coefficient was used to determine the interrater agreement between the patient and physician in the degree of nasal obstruction. The kappa coefficient was 0.03 (p value 0.372) for the comparison of the left-sided scores (fair agreement), and 0.16 (p value 0.014) for the right-sided scores (slight agreement). A comparison was also done between the side of the nose the patient felt was most obstructed to the most obstructed side found on physical exam by the otolaryngologist. Thirteen of the 38 patients (34%) had perceived nasal obstruction on the opposite side of that noted to be most obstructed on physical exam. Despite this, the kappa coefficient in this comparison was 0.43 (p value <0.001) revealing moderate agreement between the two groups. Seventeen otolaryngologists participated in the second part of the study. Data extrapolated revealed very little agreement among the physicians in reporting which side of the nose was most obstructed, what anatomical structure contributed to the obstruction the most, and what percentage obstruction was present.DiscussionBased on our findings, patients can reasonably determine based on their symptoms which side is most obstructed, but symptoms do not correlate with severity of obstruction when compared to physical exam. There is also very little consistency between otolaryngologists in their assessment of the degree of nasal obstruction on exam. The results of this study may have far-reaching implications for patient management, surgical intervention, and medicolegal documentation as it relates to the current surgical treatment of nasal obstruction.     

Correlation of subjective sensation of nasal patency with nasal inspiratory peak flow rate*

To determine the relationship between subjective sensation of nasal patency and objective measurement of nasal inspiratory peak flow rate, a longitudinal study was conducted using healthy volunteers. Five healthy medical practitioners, one woman and 4 men, aged 24–34 years, made daily subjective estimations of their sensation of nasal patency on a 10cm visual analogue scale. This was followed immediately by measurements of nasal inspiratory peak flow rate using a Youlten meter, repeated on at least 25 days per subject. Correlation coefficient and regression lines for subjective nasal patency on nasal inspiratory peak flow rate were calculated. One hundred and sixty nine sets of observations were made, range 25–44 per subject. Each subject showed strong evidence (P < 0.01) of positive correlation between subjective nasal patency score and nasal inspiratory peak flow rate. There was strong evidence (P < 0.001) that different regression lines are needed for different subjects, but no evidence that the lines are not parallel. Subjective sensation of nasal patency is strongly correlated with objective nasal patency, as measured by peak inspiratory flow rate. This relationship varies between individuals. Measurement of nasal inspiratory peak flow rate may be a valuable objective test of nasal patency, and is quick and simple to perform.     

The nasal response to isometric exercise

The cardiovascular response to isometric exercise is well understood. However, the response of the nasal mucosa is less well known. We have attempted to document this response in normal individuals. Ten individuals with no history of nasal disease or allergy were studied. All subjects were asked to perform sustained handgrip on the side of the obstructed nostril for a period of 5 min at 30% of maximum voluntary effort. Nasal cross-sectional area was measured on both sides of the nose using an acoustic rhinometer. The individuals were then rested for at least 30 min and the test repeated with pressure applied by the opposite hand. Statistical analysis was performed by non-parametric methods. There was a significant fall in nasal cross-sectional area on the side of exercise median change = 0.09 cm², P < 0.01) while cross-sectional area in the contralateral nasal passage increased (median change = 0.35 cm², p= 0.01). There was no significant differences between these results and those obtained by handgrip on the opposite side. The results indicate that isometric exercise produces nasal obstruction (isotonic exercise) and both afferent and efferent arms of this reflex are side-specific.     

Use of nasal flowmeter to measure nasal patency

We determined nasal peak flow using a peak flowmeter with a face mask (PALROD peak expiratory flowmeter) and nasal airway patency with an anterior rhinomanometer (Nihon Koden MPR-1100) at a minimum time interval in the same individual. We compared the values obtained by two kinds of measurements to evaluate the usefulness of the peak flowmeter for nasal airway patency. In this study, the nasal patencies were experimentally changed and measured in 30 patients using alpha-1 stimulant spray and in 25 patients with nasal allergy using nasal provocation of antigens. We also measured the natural circadian changes of nasal patency in 21 patients with nasal allergy and in 18 normal persons every two hours from 8:00 A.M. to 8:00 P.M. and from 9:00 A.M. to 9:00 P.M., respectively. As a result, we found close correlations between percent change of the peak flow and the nasal airway patency measured after spraying alpha-1 stimulant (r = 0.699, p less than 0.01), after antigen provocation (r = 0.585, p less than 0.01), and during circadian change (r = 0.464, p less than 0.01 in normal persons and r = 0.251, p less than 0.05 in allergy patients). In conclusion, peak flowmeter is handier and cheaper than rhinomanometer and is useful in evaluating the effect of vasoconstrictors and nasal provocation on nasal patency and in measuring the circadian changes of nasal patency. Since nasal secretion in the nose affects the measurement of peak flow, it should be removed as much as possible immediately before the flowmeter is used.     

Variations in congestion of the nasal mucosa in man

Congestion of one side of the nose is accompanied by decongestion of the other side. This is called the nasal cycle. The nasal cycle does not seem to be present in all subjects and it has not been shown with rhinostereometry. There are very few studies showing whether there are spontaneous day-to-day variations in nasal mucosal congestion and no studies showing differences in nasal mucosal congestion between morning and afternoon. This, however, may be very important in studies covering a longer period. In the present study, data from four healthy volunteers were recorded 18 or 19 times in the mornings and afternoons on different days. Measurements were made with rhinostereometry, a peak flow meter (PNIF) and by symptom scores. A nasal cycle was found in some subjects. There was no difference in total nasal mucosal swelling in the mornings and in the afternoons and no day-to-day variation in the total nasal mucosal swelling.     

Evaluation of Nasal Patency: Comparison of Patient and Clinician Assessments with Rhinomanometry

The correlation between the objective measurement of nasal resistance and nasal airflow sensation is usually regarded as poor. The aim of the study was to assess the relation between objective indices of nasal patency, as assessed by the occlusion method (RN) and the Youlten peak nasal inspiratory flow meter (PNIF), with subjective sensations of nasal blockade by either the patient or the clinician in groups of patients with rhinitis, asthma, rhinitis and asthma, nasal septal deformity and in normal controls. We studied nasal airway patency in 254 subjects (37 women, 217 men), mean age 21 years (range 14-78) by RN and PNIF. Nasal resistance was also measured by the application of Ohm's law for parallel resistors (NRO) by estimating the unilateral resistance separately. Subjective sensation of nasal blockade was assessed either by the patient on a 10-point Borg scale (SUB), or the clinician (CLN) on a 6-point scale (3 for each side of the nose). The latter was done in a controlled fashion with the aid of reference sensations. Adjusting for age, height, smoking status and airway calibre, we found good correlation between RN and CLN (r=0.57, p=10     

The limitations of peak nasal flow measurement

The Youlten Peak Nasal Flow Meter is a convenient device for obtaining objective measurements of nasal patency and gives static values which correlate well—though inversely—with resistance measured by rhinomanometry. In this study peak nasal flow and nasal resistance are compared before and after intranasal challenge using histamine. The comparatively small change in nasal resistance induced by low-dose histamine is not reliably detected by the peak flow meter. Large changes in nasal resistance with a higher dose of histamine are reflected by significant but small changes in peak nasal inspiratory flow. It is concluded that changes in nasal patency as measured by the Youlten meter are an insensitive measure of nasal patency compared with rhinomanometrically measured resistance changes. Continued use of the latter is recommended for physiological research.     

Extended observation of the nasal cycle using a portable rhinoflowmeter

OBJECTIVE: Nasal patency varies owing to the effects of humidity, temperature, and exercise. In addition, periodic cycles of congestion and decongestion that alternate between the right and the left side of the nose, which are termed the "nasal cycle," have been observed. The physiologic mechanisms underlying this cycle are not clear. Sympathetic nerves that supply the nose are regulated by the hypothalamus and the vasomotor areas of the brainstem. It is possible that the nasal cycle could be involved in protection against respiratory infection or allergies. Conventional methods of studying the nasal cycle, including rhinomanometry and acoustic rhinometry, impose limitations on the location and timing of evaluation. We studied the nasal cycle using a new portable device for relatively long-term rhinoflowmetry. METHODS: Twenty normal subjects aged 24 to 77 years were fitted with the portable rhinoflowmeter (Rhinocycle, Rhinometrics, Lynge, Denmark) to continuously measure nasal air flow via each nostril over 12 daytime hours. RESULTS: No subject complained of discomfort owing to the device, and 14 of them showed a detectable nasal cycle. The mean nasal cycle duration was 110 minutes, although variation was considerable, even in a single subject. CONCLUSIONS: The portable device proved useful for observing the nasal cycle, and it should be valuable for the general investigation of nasal physiology.     

常用减充血剂对鼻黏膜纤毛毒性的观察

目的:观察减充血剂对鼻黏膜纤毛的毒性作用,为临床选择合适的鼻腔减充血剂提供参考。方法:①选健康志愿者100例,分别用0.05%、0.025%盐酸羟甲唑啉,1.0%、0.5%麻黄素喷鼻7d,进行糖精试验以检测鼻黏膜纤毛输送率(MTR),并与对照组进行比较。②用药7d后每组各取1例下鼻甲黏膜进行扫描电镜观察。结果:①用药7d后,0.05%盐酸羟甲唑啉组鼻黏膜纤毛MTR为(7.64±1.56)mm/min;0.025%盐酸羟甲唑啉组为(7.46±1.65)mm/min,其差异无统计学意义(P>0.05);1.0%麻黄素组为(4.73±2.03)mm/min;0.5%麻黄素组为(4.38±2.04)mm/min,其差异亦无统计学意义(P>0.05)。0.05%、0.025%盐酸羟甲唑啉组分别与对照组[(7.14±1.76)mm/min]比较,差异无统计学意义(均P>0.05);1.0%、0.5%麻黄素组分别与对照组比较,差异有统计学意义(均P<0.01)。0.05%、0.025%盐酸羟甲唑啉组分别与1.0%、0.5%麻黄素组比较,差异有统计学意义(均P<0.05)。②电镜观察:1.0%、0.5%麻黄素组黏膜上皮纤毛脱落,0.05%、0.025%盐酸羟甲唑啉组纤毛排列整齐。结论:麻黄素对鼻黏膜纤毛有不良影响;盐酸羟甲唑啉对鼻黏膜纤毛无明显影响,没有破坏鼻黏膜纤毛的正常生理功能,是理想的鼻腔减充血剂。