丙酸氟替卡松鼻喷剂对伴和不伴变应性鼻炎的腺样体肥大儿童的疗效比较

摘要

目的 探讨儿童变应性鼻炎(allergic rhinitis,AR)与腺样体肥大两者关系,以及治疗的相互联系.方法 选取腺样体肥大患儿98例,其中单纯腺样体肥大患儿52例(53.1%),腺样体肥大合并变应性鼻炎患儿46例(46.9%)给予辅舒良(丙酸氟替卡松喷剂)持续喷鼻3月.结果 单纯腺样体肥大儿童52例,治疗后有效腺样体体积有效减小31例,有效率为59.6%.腺样体肥大伴变应性鼻炎儿童46例,治疗后有效腺样体体积有效减小38例,有效率为82.6%.两组有效率比较有显著差异(x2=18.04, P<0.01).结论 儿童腺样体肥大是多因素结果.变应性鼻炎炎症因子是大龄儿童腺样体肥大的主要发病机制之一.儿童腺样体肥大合并变应性鼻炎儿童可经鼻用糖皮质激素治疗后腺样体体积减小程度较单纯腺样体肥大患者明显,对儿童变应性鼻炎合并腺样体肥大优先考虑鼻类固醇激素治疗过敏性鼻炎.%Objective To investigate the relationship between children allergic rhinitis ( AR ) and adenoid hypertrophy, and the relationship between the treatment.Methods 98 cases of children with adenoid hypertrophy were selected,of which 52 cases(53.1 % )were adenoid hypertrophy alone,and 46 cases(46.9 %)were combined with allergic rhinitis given flixonase(fluticasone propionate spray)for 3 months.Results 52 cases of children with adenoid hypertrophy alone, effective adenoid volume decreased after treatment in 31 cases, the effective rate was 59.6 %. Adenoid hypertrophy in 46 cases of children with allergic rhinitis, the effective adenoid volume decreased in 38 cases,the effective rate was 82.6 %.There was significant difference between two groups(x2=18.04.P<0.01). Conclusions Adenoid hypertrophy in children is a multi-factor result. Allergic rhinitis inflammatory cytokines is one of the main pathogenesis of adenoid hypertrophy in older children.Children with adenoid hyperplasia combined with allergic rhinitis can be treated by intranasal steroid, the reduction of adenoid size is more obvious than that of patients with simple adenoid hypertrophy. We can give priority to intranasal steroid hormone treatment in children with allergic rhinitis combined with adenoid hypertrophy.