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目的:探讨麻黄碱试验在鼻声反射(AR)中的临床应用,研究定量评价鼻腔黏膜状态的方法和鉴别单纯性鼻炎与肥厚性鼻炎的客观指标。方法:利用AR测试单纯和肥厚性鼻炎患者,并设正常对照,通过麻黄碱试验深入分析试验前后鼻气道通气阻力(NAR)、鼻腔容积(NCV)、鼻腔最小截面积(NMCA)和NMCA所处的位置相对于鼻腔入口处的距离(DCAN)以及上述参数的变化量和变化率,定量分析3类受试者的鼻黏膜舒缩状态。结果:麻黄碱试验前后成对资料比较,各基本参数均差异有统计学意义(均P<0.01),麻黄碱试验后NAR减小,NCV增加,并伴有NMCA扩大和DCAN的“前移”。麻黄碱试验前后各组各参数的均数多组间的均差异有统计学意义(均P<0.01)。2个患者组之间相比,麻黄碱试验前只有NCV有统计学意义(P<0.05),而麻黄碱试验后所有参数(包括变化量和变化率)的均差异有统计学意义(P<0.05或P<0.01)。与正常对照,单纯性鼻炎所有参数(包括变化量和变化率)的均差异有统计学意义(P<0.05或P<0.01),而肥厚性鼻炎的某些参数的变化量和变化率的差异则无统计学意义。结论:AR能客观的判断鼻黏膜的状态,结合麻黄碱试验能提供更多的信息,扩大了AR的临床应用,建议作为常规配套检查。
Objective: To investigate the clinical application of ephedrine test in nasal reflection (AR), to study the method of quantitative evaluation of nasal mucosa status and to identify the objective indexes of simple rhinitis and hypertrophic rhinitis. Methods: Nasal airway resistance (NAR), nasal volume (NCV), nasal minimal cross-sectional area (NMCA) and NMCA were measured by ephedrine test before and after the test. Nasal mucosal contractile status of the three categories of subjects was quantitatively analyzed with respect to the distance at the entrance to the nasal cavity (DCAN) and the amount and rate of change of the above parameters. Results: Before and after the ephedrine test, there were significant differences in the basic parameters between the two groups (all P <0.01). After the ephedrine test, the NAR decreased and the NCV increased with the extension of NMCA and the “forward” . Before and after the ephedrine test, the mean of each parameter in each group was significantly different (all P <0.01). Only the NCV before ephedrine test was statistically significant (P <0.05) between the two groups, and all the parameters (including changes and changes) after ephedrine test were statistically significant (P < 0.05 or P <0.01). Compared with the normal control, all the parameters of simple rhinitis (including the change and the rate of change) were significantly different (P <0.05 or P <0.01), while the changes of some parameters and the rate of change of hypertrophic rhinitis No statistical significance. Conclusion: AR can objectively judge the status of nasal mucosa, combined ephedrine test can provide more information and expand the clinical application of AR, it is recommended as a routine supporting inspection.