口腔径路曲安奈德蝶腭神经节封闭治疗变应性鼻炎（附415例报告）

目的：探讨口腔径路曲安奈德蝶腭神经节封闭治疗变应性鼻炎的效果。方法：变应性鼻炎患者415例，男270例，女145例。用自制封闭针头于口腔径路行曲安奈德蝶腭神经节封闭术。结果：415例中，有效250例，好转63例，总有效率为99．5％。结论：经口腔径路用曲安奈德行蝶腭神经节封闭术是治疗变应性鼻炎的有效疗法。     

How do topical nasal corticosteroids improve sleep and daytime somnolence in allergic rhinitis?

Therapy for rhinitis improves sleep quality and symptoms of daytime sleepiness. This improvement with therapy may be secondary to anti-inflammatory effects, leading to a reduction of inflammatory mediators, or to a mechanical reduction of congestion directly leading to improvement in sleep disturbance. We combined our data from 3 placebo-controlled studies of intranasal corticosteroids in patients with perennial rhinitis to determine whether a correlation between the reduction of congestion and improved sleep and daytime somnolence existed. The pooled data of budesonide, flunisolide, and fluticasone demonstrated significantly decreased nasal congestion, sleep problems, and sleepiness in treated patients. The data demonstrated a correlation between a reduction in nasal congestion and an improvement of sleep (P < .01) and daytime somnolence (P = .01). Thus, topical intranasal corticosteroids should be used to decrease nasal congestion and to improve sleep and daytime somnolence in patients manifesting these symptoms.     

血管运动性鼻炎激光治疗鼻腔粘膜致敏区的筛选

目的 :随访和对比激光治疗血管运动性鼻炎鼻腔粘膜不同区域的致敏性 ,以明确最佳治疗点。方法 :随机选择确诊的血管运动性鼻炎 1 0 3例 ,分为下鼻甲、中鼻甲、中鼻甲前 1 /3段 3组进行激光治疗。结果 :下鼻甲组总有效率为 66.7% ,中鼻甲组为 97.1 % ,中鼻甲前 1 /3段为 94.4% ,两中鼻甲组与下鼻甲组总有效率差异有显著性 (P<0 .0 0 5) ,中鼻甲组与中鼻甲前 1 /3段组总有效率差异无显著性 (P>0 .0 5)。结论 :中鼻甲前 1 /3段是血管运动性鼻炎患者鼻粘膜最敏感的区域 ,是最佳激光治疗点。     

蝶腭,筛前神经及鼻甲联合手术治疗常年性变应性鼻炎

在鼻内窥镜下为４０例行蝶腭、筛前神经及鼻甲联合手术治疗常年性变应性鼻炎。结果：术后１月全部患者症状消失,显效１００％;术后１年显效３３例,占８２．５％;有效６例,占１５％,有效率为９７．５％。提示该方法可广泛阻滞鼻腔副交感神经来源,降低鼻粘膜感觉灵敏部位敏感性以及感觉—副交感神经反射,破坏喷嚏反射弧的传入通路,使鼻粘膜对外界刺激敏感性下降,血管扩张减轻,腺体分泌减少,对常年性变应性鼻炎有明显疗效。     

变应性鼻炎患者外周血白细胞及鼻黏膜诱导型一氧化氮合酶mRNA 表达的意义

目的　探讨变应性鼻炎 (allergicrhinitis,AR)患者外周血白细胞及鼻黏膜诱导型一氧化氮合酶 (induciblenitricoxidesynthase,iNOS)mRNA表达的关系。方法　选择 3 5例AR患者及 3 0例健康人的外周血白细胞。其中 8例变应性鼻炎患者鼻黏膜 ,6例正常鼻黏膜。iNOS mRNA表达采用原位杂交方法。血浆一氧化氮 (nitricoxide,NO)水平采用硝酸还原酶比色法测定。结果　健康人外周血白细胞未见iNOS mRNA表达 ,而AR患者外周血白细胞iNOS mRNA表达高度增强 ,其阳性率达 40 82 %。正常人鼻黏膜上皮、腺体及巨噬细胞可见iNOS mRNA的低度表达 ,而AR患者中上皮、腺体及巨噬细胞增生 ,并iNOS mRNA表达高度增强 (t=2 3 17,P <0 0 0 1)。AR组血浆NO水平显著高于对照组 (t=2 7 89,P <0 0 1)。结论　AR患者血浆NO水平与外周血白细胞及组织内iNOS mRNA表达高度增强有关。提示iNOS NO通路在AR的发病过程中可能起重要作用。本研究为检测体内某些信号提供了简便易行的原位杂交试验方法     

In vitro expression of inducible nitric oxide synthase in the nasal mucosa of guinea pigs after incubation with lipopolysaccharides or cytokines

In order to demonstrate the involvement of nitric oxide synthases (NOS) – in particular the inducible isoform (iNOS) – in inflammatory processes within the nasal airways, we used organ-bath incubation to study isolated inferior turbinates and mucosa of the maxillary sinus of guinea pigs. The pattern of the expression in various substructures of the nasal mucosa was of special interest. Mucosa was incubated for 6 h with lipopolysaccharides (LPS) produced by E. coli, interleukin II (IL-2) or tumor necrosis factor-alpha (TNF-α). Saline was used as the control solution. Following incubation the specimens were fixed in buffered 4% formaldehyde solution over a period of 4 h. Tissues were next exposed to nicotinamide adenine dinucleotide phosphate (NADPH)-diaphorase-reaction and immunostained with specific antibodies to iNOS. Results then showed a clearly increased or initiated expression of iNOS in epithelium, glands, leucocytes and blood vessels of treated tissues in comparison to the control specimens. The inflammatory mediator LPS and the cytokines Il-2 or TNF-α alone were found to be capable of increasing the expression of iNOS, although the effects of LPS clearly exceeded those of the cytokines. This finding implicates iNOS-generated nitric oxide as a key factor for causing nasal swelling, secretion and obstruction during nasal infections and allergic episodes. Received: 18 November 1997 / Accepted: 22 April 1998     

白细胞介素-18在变应性鼻炎中的作用

目的 :探讨白细胞介素 18(IL 18)在变应性鼻炎发生发展中的作用。方法 :采用双抗体夹心ELISA法检测 30例变应性鼻炎患者 (鼻炎组 )和 2 0例健康志愿者 (对照组 )血清中IL 18的含量。结果 :鼻炎组血清IL 18含量 [(4 2 4 .12± 6 0 .4 7)ng/L]高于对照组 [(2 10 .71± 5 7.37)ng/L],其差异有统计学意义 (P <0 .0 1) ;变应性鼻炎伴哮喘者 [(5 91.19± 4 6 .5 4 )ng/L]高于不伴哮喘者 [(35 2 .5 2± 6 4 .2 5 )ng/L],其差异亦有统计学意义 (P <0 .0 5 )。结论 :变应性鼻炎患者血清IL 18表达增高 ,在变应性炎症的持续存在和恶化过程中起重要作用。     

变应性鼻炎神经肽与肥大细胞关系的实验研究

目的:探讨辣椒素治疗实验性变应性鼻炎的机制,进一步研究变应性鼻炎中神经肽与肥大细胞之间的关系。方法:健康SD大鼠30只,随机分为自然对照组、变应性鼻炎组和辣椒素治疗组,每组各10只。用卵清蛋白腹腔注射免疫,继之鼻腔局部免疫建立大鼠变应性鼻炎模型,并进行辣椒素治疗2周,观察各组大鼠行为学改变,取各组动物的鼻黏膜行常规苏木精-伊红染色、甲苯胺蓝染色及免疫组织化学染色,计数并比较肥大细胞在各组之间的差异,观察P物质(SP)在鼻黏膜中分布密度的差异。结果:变应性鼻炎组肥大细胞计数大于自然对照组(P<0.01)。辣椒素治疗组肥大细胞少见,低于变应性鼻炎组(P<0.01);SP的表达低于变应性鼻炎组(P<0.01),但与自然对照组比较差异无统计学意义(P>0.05)。组织中SP的表达与肥大细胞浸润有一定的正相关性(r=0.8252,P<0.05)。结论:辣椒素治疗变应性鼻炎模型可有效减少肥大细胞的浸润,使SP表达减少,各种过敏症状明显改善。     

Effects of point application on celiac mast cell degranulation in mice with allergic rhinitis: An experimental study

目的：研究不同处理方法对卵白蛋白（Ovum Albumin,OVA）变应性鼻炎小鼠模型腹腔肥大细胞脱颗粒的影响。方法：将60只雌性小鼠随机分为5组,每组12只,分别按不同方法处理后分离各组小鼠的腹腔肥大细胞,中性红染色后计算腹腔肥大细胞脱颗粒率。结果：正常对照组、OVA变应性鼻炎组、穴位敷贴组、激素对照组、磷酸盐缓冲液（Phosphate Buffer Saline,PBS）阴性对照组小鼠腹腔肥大细胞脱颗粒率分别为（15±6）％、（53±11）％、（37±13）％、（31±15）％、（47±14）％。OVA变应性鼻炎小鼠的腹腔肥大细胞有明显的脱颗粒现象：与OVA变应性鼻炎小鼠相比,穴位敷贴组及激素对照组小鼠的腹腔肥大细胞脱颗粒现象显著减轻;PBS对照组小鼠的腹腔肥大细胞脱颗粒现象没有明显变化。结论：推测穴位敷贴抗过敏机制为稳定肥大细胞膜,抑制肥大细胞脱颗粒,减少致炎介质产生。     

SB328437干预小鼠变应性鼻炎模型的实验研究

目的探讨趋化因子受体3(CCR3)拮抗剂SB328437在小鼠变应性鼻炎模型中的防治作用。方法将30只6～8周BALB/c小鼠随机分为变应性鼻炎组(A组)、SB328437治疗组(B组)和正常对照组(C组),每组10只。以卵清白蛋白(OVA)致敏建立变应性鼻炎模型,B组每次激发前0.5h以SB328437 0.8 mL腹壁皮下注射,10μL滴鼻。比较各组小鼠变应性鼻炎症状评分、鼻黏膜嗜酸性粒细胞(EOS)计数、血清IgE含量以及鼻黏膜CCR3荧光强度。结果A、B、C组的症状评分分别为(7.6±1.9)、(0.7±0.6)和(0.5±0.3)分,A组与B、C组的差异均有统计学意义(P值均<0.01),B组与C组的差异无统计学意义(P>0.05)。A、B、C组的EOS计数分别为7.8±1.8、1.6±0.9和0.5±0.3,A组与B、C组的差异均有统计学意义(P值均<0.01),B组与C组的差异无统计学意义(P>0.05)。A、B、C组血清总IgE分别为(120.59±7.92)、(71.77±6.54)和(18.68±4.76)ng/mL,3组间的差异有统计学意义(P<0.01)。B组鼻黏膜CCR3荧光强度低于A组。结论SB328437可抑制小鼠变应性鼻炎,有可能成为变应性鼻炎免疫治疗的一种新方法。