美泊利珠单抗用于嗜酸粒细胞性慢性鼻窦炎伴鼻息肉鼻内窥镜手术后维持治疗的效果分析 点击下载
| 论文标题： | 美泊利珠单抗用于嗜酸粒细胞性慢性鼻窦炎伴鼻息肉鼻内窥镜手术后维持治疗的效果分析 |
| 英文标题： | |
| 中文摘要： | 目的 评估美泊利珠单抗用于嗜酸粒细胞性慢性鼻窦炎伴鼻息肉（EosCRSwNP）患者鼻内窥镜手术（ESS）术后维持治疗的效果。方法采用回顾性队列研究，收集2025年1月1日－5月31日于徐州市第一人民医院耳鼻喉科接受ESS治疗的EosCRSwNP患者的临床资料，根据术后维持治疗方案的不同分为对照组（56例，术后接受鼻用糖皮质激素治疗）和观察组（51例，术后接受美泊利珠单抗治疗）。比较两组患者在术后2周和3、6个月时的鼻功能指标[鼻腔容积（NCV）、最小横截面至前鼻孔距离（DCAN）、鼻腔最小横截面积（NMCA）、糖精清除时间、鼻黏液纤毛清除率、黏液纤毛清除速率]、鼻黏膜重塑相关指标[外周血嗜酸粒细胞（EOS）比例和血清转化生长因子β（1TGF-β1）、血管内皮生长因子（VEGF）水平]，比较其术后2周和6个月时的鼻腔黏膜炎症状态[改良Lund-Kennedy鼻内镜评分系统（MLK）评分]、鼻息肉复发程度[鼻息肉评分（NPS）]、生活质量[鼻腔鼻窦结局测试20（SNOT-20）评分]评估指标，记录两组患者的不良反应发生情况。结果两组患者术后2周时上述指标/评分比较，差异均无统计学意义（P＞0.05）。与同组术后2周时比较，两组患者术后3、6个月时的NCV、NMCA、鼻黏液纤毛清除率、黏液纤毛清除速率均显著升高，术后3、6个月时DCAN、糖精清除时间、EOS比例、TGF-β1和VEGF水平以及术后6个月时的MLK评分、NPS、SNOT-20评分均显著降低或缩短（P＜0.05）；且观察组上述指标的改善均较同期对照组显著（P＜0.05）。两组患者的总体不良反应发生率相当（P＞0.05），但观察组患者注射部位反应的发生率显著高于对照组（P＜0.05）。结论美泊利珠单抗用于EosCRSwNP患者ESS术后维持治疗，可促进鼻功能恢复、改善鼻黏膜重塑相关指标、减轻炎症、降低鼻息肉评分、提高生活质量，效果优于鼻用糖皮质激素，但临床需注意注射部位反应的发生风险。 |
| 英文摘要： | OBJECTIVE To investigate the clinical efficacy of mepolizumab as postoperative maintenance therapy after endoscopic sinus surgery （ESS） in patients with eosinophilic chronic rhinosinusitis with nasal polyps （EosCRSwNP）.METHODS A retrospective cohort study was conducted to collect clinical data from patients with EosCRSwNP who underwent ESS at the Dept. of Otolaryngology in Xuzhou First People’s Hospital， from January 1 to May 31， 2025. Patients were divided into a control group （56 cases， treated with intranasal corticosteroids postoperatively） and an observation group （51 cases， treated with mepolizumab postoperatively） based on their postoperative maintenance therapy regimens. The nasal function parameters [nasal cavity volume （NCV）， distance from the minimum cross-sectional area to the anterior nostril （DCAN）， nasal minimum cross-sectional area （NMCA）， saccharin clearance time， nasal mucociliary clearance rate， mucociliary clearance velocity]， and the indicators related to nasal mucosal remodeling [peripheral blood eosinophil （EOS） percentage， serum levels of transforming growth factor-β 1 （TGF-β 1 ） and vascular endothelial growth factor （VEGF）] were compared between the two groups at 2 weeks and 3， 6 months after surgery. The assessment indicators of the inflammation status of nasal mucositis [modified Lund-Kennedy Endoscopic Scoring System （MLK） score]， the degree of nasal polyp recurrence[nasal polyp score （NPS）]， and the quality of life [Sino-nasal Outcome Test-20 （SNOT-20） score] were compared at 2 weeks and 6 months after surgery. Adverse events were also recorded and compared between the two groups.RESULTS At 2 weeks after surgery， there were no statistically significant differences in the aforementioned indicators/scores between the two groups （ P ＞0.05）. Compared with the same group at 2 weeks postoperatively， both groups showed significant increases in NCV， NMCA， nasal mucociliary clearance rate， and mucociliary clearance velocity at 3 and 6 months postoperatively； significant decreases or reductions were observed in DCAN， saccharin clearance time， EOS percentage， TGF-β 1 and VEGF levels at 3 and 6 months postoperatively， while in MLK score， NPS， SNOT-20 score were all significantly reduced or shortened （ P ＜0.05）. Furthermore， the improvements in these indicators in the observation group were significantly greater than those in the control group during the same time periods （ P ＜0.05）. The overall incidence of adverse reactions was comparable between the two groups （ P ＞0.05）， but the incidence of injection-site reactions was significantly higher in the observation group than in the control group （ P ＜0.05）.CONCLUSIONS The use of mepolizumab for postoperative maintenance therapy following ESS in patients with EosCRSwNP promotes the recovery of nasal function， improves indicators of nasal mucosal remodeling， reduces inflammation， lowers polyp score， and enhances quality of life. Its efficacy is superior to that of intranasal corticosteroids； however， clinicians should be mindful of the risk of injection-site reactions of mepolizumab. |
| 期刊： | 2026年第37卷第16期 |
| 作者： | 丁锐；陈力；蔡博宇；梁言 |
| 英文作者： | DING Rui，CHEN Li，CAI Boyu，LIANG Yan |
| 关键字： | 美泊利珠单抗；嗜酸粒细胞性鼻窦炎伴鼻息肉；鼻内镜手术；术后维持治疗 |
| KEYWORDS： | mepolizumab;eosinophilic chronic rhinosinusitis with nasal polyps;Endoscopic sinus surgery;postoperative maintenance therapy |
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