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目的探讨变应性鼻炎(AR)儿童在接受布地奈德喷鼻治疗前后鼻分泌物涂片嗜酸性粒细胞(EOS)百分比(EOS%)的变化。方法收集确诊为持续性AR且近1个月内未接受布地奈德喷鼻治疗的92例儿童为研究对象。对其症状、体征进行评分,检查其鼻分泌物EOS%。予布地奈德喷鼻治疗,并于布地奈德喷鼻治疗前与喷鼻治疗1个月、治疗2个月进行其鼻分泌物EOS%检查,观察其变化。同时根据症状、体征评分判定疗效。结果 1.布地奈德喷鼻治疗1个月总有效率为84.78%,治疗2个月总有效率为94.57%,二者比较差异有统计学意义(χ2=6.197,P=0.045)。2.治疗前鼻分泌物EOS%重度的67例患儿,治疗1个月48例鼻分泌物EOS%下降,治疗2个月64例鼻分泌物EOS%下降,治疗2个月鼻分泌物EOS%下降率显著高于治疗1个月(χ2=12.240,P<0.001)。治疗前鼻分泌物EOS%中度的17例患儿中,治疗1个月12例鼻分泌物EOS%下降,治疗2个月16例鼻分泌物EOS%下降,治疗1个月与2个月的鼻分泌物EOS%下降率比较差异无统计学意义(χ2=3.690,P>0.05)。结论 EOS为AR的主要炎性细胞之一,布地奈德喷鼻剂能迅速降低AR患儿鼻分泌物中EOS比例,鼻分泌物EOS%可作为儿童AR疗效判定的指标。
Objective To investigate the changes of nasal secretion eosinophils (EOS%) in children with allergic rhinitis (AR) before and after receiving budesonide nasal spray. Methods Ninety-two children who were diagnosed as persistent AR and who had not received budesonide nasal spray in the recent 1 month were enrolled in this study. The symptoms and signs were scored and examined for nasal secretions EOS%. Budesonide nasal spray treatment, and budesonide nasal spray treatment with nasal spray for 1 month, 2 months of treatment of nasal secretions EOS% check to observe the changes. At the same time according to the symptoms, signs score to determine efficacy. The total effective rate of budesonide nasal spray for one month was 84.78%, and the total effective rate for two months was 94.57%. The difference was statistically significant (χ2 = 6.197, P = 0.045). 2. Pre-treatment EOS% of nasal secretions 67 cases of severe cases, 48 cases of nasal secretions EOS% decreased 1 month after treatment, 64 cases of nasal secretions EOS% decreased 2 months treatment of 2 months of nasal secretions EOS % Decline rate was significantly higher than the treatment for 1 month (χ2 = 12.240, P <0.001). Pretreatment nasal secretions EOS moderate 17 cases of children, treatment of 1 month 12 cases of nasal secretions EOS% decreased 2 months treatment of 16 cases of nasal secretions EOS% decline in the treatment of 1 month and 2 months The nasal secretions EOS% decline rate was no significant difference (χ2 = 3.690, P> 0.05). Conclusions EOS is one of the major inflammatory cells in AR. Budesonide nasal spray can rapidly decrease the proportion of EOS in nasal secretions of AR children. EOS% of nasal secretions can be used as an indicator of AR efficacy in children.