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。

The observation of the ciliotoxicity of nasalmucosal with nasal decongestant

OBJECTIVE: To study the ciliotoxicity of nasalmucosal with nasal decongestant, in order to choose the appropriate nasal decongestant. METHOD: (1) Selected 100 healthy volunteers, by using 0.05% hydrochloride oxymetazoline, 0.025% hydrochloride oxymetazoline, 1.0% ephedrine and 0.5% ephedrine for 7 days with sacchariu technique to test nasal mucociliary transport, and compared with the normal saline. (2) To observe the mucosa of inferior turbinate with Electron Microscopy. RESULT: After using nasal decongestant for 7 days, Mean nasal mucociliary transport rat (MTR) in 0.0500 hydrochloride oxymetazoline groups was (7.64+/-1.56) mm/min and (7.46+/-1.65) mm/min in 0.25% hydrochloride oxymetazoline groups, Mean nasal mucociliary transport rat (MTR) in 1.0% ephedrine groups was (4.73+/-2.03) mm/min and (4.38+/-2.04) mm/min in 0.5% ephedrine groups,The normal saline groups was (7.14+/-1.76) mm/min. MTR was obviously different (F = 16.50, P <0.01). (2)With electron microscopy, it was found that the cilia of epithelial cells were in good order, uniformed in hydrochloride oxymetazoline groups and exfoliated in ephedrine groups. CONCLUSION: Ephedrine has ill effects on nasal mucosa; Hydrochloride oxymetazoline has neither effect on nasal mucosa, nor destroying the physical function of nose, it is an ideal nasal decongestant.