摘要： 目的 探讨鼻内镜高选择性鼻部神经阻断术对中重度变应性鼻炎（AR）患者的疗效及血清血管活性肠肽（VIP）表达的影响。方法 选取行鼻内镜高选择性鼻部神经阻断术治疗的中、重度AR患者30例，分别于术前、术后1年用症状VAS评分评估手术疗效，同时检测患者外周血血清中VIP浓度的变化，并分析两者的相关性。结果 与术前比较，鼻内镜高选择性鼻部神经阻断术后1年各症状VAS评分均下降，显效率为53.3%（16/30），有效率为46.7%（14/30）； VIP水平明显降低［ （18.42±0.64） pg/mL vs （39.89±1.30） pg/mL，P < 0.05］，且与VAS评分呈直线正相关（r²=0.77）。结论 高选择性鼻部神经阻断术可有效改善中重度变应性鼻炎患者的临床症状，其机制可能与降低患者体内VIP的水平有关。

高选择性鼻部神经阻断术对中重度变应性鼻炎的疗效及血管活性肠肽表达的影响

杨昕^1,2, 杨杨³, 邰旭辉², 陈冬⁴

1. 锦州医科大学北部战区空军医院研究生培养基地, 辽宁 锦州 121011;
2. 中国人民解放军北部战区空军医院耳鼻喉科, 全军耳鼻喉研究中心, 沈阳 110042;
3. 沈阳医学院基础部机能与形态教学实验中心, 沈阳 110034;
4. 锦州医科大学附属第一医院耳鼻咽喉头颈外科, 辽宁 锦州 121001

收稿日期:2021-02-18出版日期:2021-11-30发布日期:2021-11-04
通讯作者:陈冬E-mail:entdoctorchen@163.com
作者简介:杨昕(1986-),女,主治医师,硕士研究生.
基金资助:辽宁省自然科学基金（20180530067）；沈阳市科学技术计划（191124016）


关键词: 神经分支阻断术, 高选择性, 鼻内镜手术, 变应性鼻炎, 血管活性肠肽
Abstract: Objective To investigate the effect of highly selective nasal endoscopic nerve blockade on patients with moderate or severe allergic rhinitis (AR) and its effect on the expression of vasoactive intestinal peptide (VIP) in serum. Methods Thirty patients with moderate or severe AR who underwent highly selective nasal endoscopic nerve blockade in our department were selected. The visual analog scale (VAS) score were used to evaluate surgical efficacy. Peripheral blood of patients was collected before and one year after surgery, and the concentration of VIP in serum was detected by ELISA to assess for the changes in VIP expression. Results One year after neurotomy, the VAS scores of all symptoms were decreased, the significant efficiency was 53.3% (16/30), the effective rate was 46.7% (12/30), the serum VIP concentration of the patients after surgery was significantly lower than that before surgery (18.42±0.64 pg/mL vs 39.89±1.30 pg/mL), there was a positive linear correlation between VIP concentration and VAS scores (r²=0.77), and all the differences were statistically significant (P < 0.05). Conclusion Highly selective nasal endoscopic nerve blockade can effectively improve clinical symptoms in patients with moderate or severe AR, and the mechanism may involve the reduction of the production of VIP.
Key words: nerve branch blockade, high selectivity, endoscopic nasal surgery, allergic rhinitis, vasoactice intestinal peptide
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