本文關(guān)鍵詞： 維生素D 嗜酸性粒細(xì)胞 過敏性鼻炎 藥物治療　出處：《安徽醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的研究成人難治性變應(yīng)性鼻炎(AR)患者血清1,25-二羥維生素D3及嗜酸性粒細(xì)胞水平,并且觀察維生素D鈣咀嚼片在該類患者應(yīng)用過程中的臨床療效,為成人難治性變應(yīng)性鼻炎的臨床診斷和治療提供進(jìn)一步的理論依據(jù)。方法研究的對象為2014年5月-2015年11月安徽醫(yī)科大學(xué)第一附屬醫(yī)院門診收治的60例成人難治性中重度AR患者。所有患者均在治療前進(jìn)行皮膚點刺試驗和血清特異性Ig E檢測,同時檢測血清1,25-二羥維生素D3及嗜酸性粒細(xì)胞的水平。該60例患者隨機分為實驗組及對照組并給予不同的治療,每組各30例。同時于我院健康體檢門診隨機選取60名健康人群的血清維生素D及嗜酸性粒細(xì)胞水平作為健康人群組。對照組患者聯(lián)合使用丙酸氟替卡松鼻噴霧劑及左西替利嗪,實驗組在對照組的基礎(chǔ)上加用維生素D鈣咀嚼片。分別于治療前、治療后兩周、治療后四周采用視覺模擬評分量表(VAS)對總體癥狀及鼻部分類癥狀進(jìn)行臨床療效評分。結(jié)果皮膚點刺試驗結(jié)果:過敏性鼻炎患者皮膚變應(yīng)原檢測陽性結(jié)果60例,占總數(shù)的100%。其中對單一過敏原致敏的13例,占總數(shù)的(21.6%)。對兩種及兩種以上過敏原致敏的47例,占總數(shù)的(78.4%)。血清特異性Ig E檢測:過敏性鼻炎患者血清特異性Ig E檢測陽性結(jié)果60例,占總數(shù)的100%。過敏性鼻炎患者血清1,25-二羥維生素D3的含量為(17.46±4.94)ng/ml,明顯低于健康人群組(21.70±7.32)ng/ml,二組差異有統(tǒng)計學(xué)意義(P0.05)。過敏性患者血清嗜酸性粒細(xì)胞的含量為1.76×109/L明顯高于健康人群組0.46×109/L,二組差異有統(tǒng)計學(xué)意義(P0.05)。治療前實驗組患者和對照組患者總體癥狀及鼻部癥狀評分均相近,差異無統(tǒng)計學(xué)意義;實驗組和對照組患者治療14天后與治療前比較,評分均明顯下降,差異有統(tǒng)計學(xué)意義;實驗組和對照組患者治療28天后與治療14天后比較,除流涕癥狀無明顯差異外,其余癥狀評分實驗組較對照組均明顯下降,差異有統(tǒng)計學(xué)意義。治療14天后實驗組與對照組相比鼻塞、鼻癢、噴嚏無明顯差異,實驗組的流涕及總體癥狀評分較對照組明顯下降,差異均有統(tǒng)計學(xué)意義。治療28天后實驗組總體癥狀及鼻部癥狀評分均低于對照組,差異有統(tǒng)計學(xué)意義。結(jié)論難治性過敏性鼻炎患者中普遍存在血清1,25-二羥維生素D3的缺乏及嗜酸性粒細(xì)胞的升高。在治療難治性過敏性鼻炎時,加用維生素D鈣咀嚼片可以更有效的控制過敏性鼻炎的相關(guān)癥狀。
[Abstract]:Objective to study the serum levels of 1m25-dihydroxyvitamin D3 and eosinophil in adult patients with refractory allergic rhinitis (ARA). And to observe the clinical effect of vitamin D calcium chewable tablets in this kind of patients. To provide further theoretical basis for the clinical diagnosis and treatment of refractory allergic rhinitis in adults. Methods from May 2014 to November 2015, the subjects of this study were admitted to the outpatient clinic of the first affiliated Hospital of Anhui Medical University. 60 adult patients with refractory moderate and severe AR were treated with skin prick test and serum specific Ig before treatment. E test. At the same time, the serum levels of 1b25-dihydroxyvitamin D3 and eosinophils were measured. The 60 patients were randomly divided into experimental group and control group and treated with different treatments. At the same time, the serum vitamin D and eosinophil levels of 60 healthy people were randomly selected as a healthy group. The patients in the control group were treated with fluticasone propionate nasal spray. Aerosols and levo-cetirizine. The experimental group was treated with vitamin D calcium chewable tablets on the basis of the control group. Visual analogue scale (VAS) was used four weeks after treatment. Results the results of skin prick test showed that 60 patients with allergic rhinitis had positive skin allergen test. 13 cases were sensitized to a single allergen, and 47 cases were sensitized to two or more allergens. Serum specific IgE was detected in 60 patients with allergic rhinitis, accounting for 100% of the total. The content of 25-dihydroxyvitamin D3 was 17.46 鹵4.94 ng / ml, which was significantly lower than that of healthy group (21.70 鹵7.32 ng / ml). The serum eosinophil content in allergic patients was 1.76 脳 10 9 / L, which was significantly higher than that in healthy subjects (0.46 脳 10 9 / L). The difference between the two groups was statistically significant (P 0.05). The scores of the overall symptoms and nasal symptoms of the patients in the experimental group and the control group were similar before treatment, but the difference was not statistically significant. The scores of the patients in the experimental group and the control group decreased significantly after 14 days of treatment compared with those before treatment, and the difference was statistically significant. After 28 days of treatment and 14 days after treatment, the scores of other symptoms in the experimental group and the control group were significantly lower than those in the control group, except that there was no significant difference in the symptoms of snot. After 14 days of treatment, there was no significant difference in nasal congestion, itching and sneezing between the experimental group and the control group. The score of runny and overall symptoms in the experimental group was significantly lower than that in the control group. After 28 days of treatment, the scores of overall symptoms and nasal symptoms in the experimental group were lower than those in the control group, and the difference was statistically significant. Conclusion Serum 1 is common in the patients with refractory allergic rhinitis. In the treatment of refractory allergic rhinitis, the addition of vitamin D calcium chewable tablets can more effectively control the symptoms of allergic rhinitis.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R765.21

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 劉永平;陳蘊光;鄭俊斌;王珊;;變應(yīng)性鼻炎鼻激發(fā)后鼻腔分泌物嗜酸性粒細(xì)胞增加與血清特異性IgE水平正相關(guān)[J];細(xì)胞與分子免疫學(xué)雜志;2017年01期

2 陳松;鐘春燕;滕勇;;過敏性疾病患者血清維生素D的營養(yǎng)狀況[J];營養(yǎng)學(xué)報;2014年03期

3 曹建偉;丁俊彩;;CD8~+CD28~+/CD8~+CD28~-T細(xì)胞在過敏性鼻炎患兒外周血中的表達(dá)[J];廣東醫(yī)學(xué);2012年24期

4 彭靜;曹祥山;邱國強;孫冠星;;1,25(OH)_2維生素D_3對人樹突狀細(xì)胞成熟及其介導(dǎo)免疫耐受的影響[J];中國實驗血液學(xué)雜志;2012年03期

5 丁曉飛;張青麗;郝莉;李冰燕;張增利;;1,25(OH)_2D_3對巨噬細(xì)胞吞噬金黃色葡萄球菌過程的影響[J];營養(yǎng)學(xué)報;2010年02期

6 夏俊波;宋云熙;曾雪峰;王彥;王長征;;1,25二-羥維生素D_3處理樹突狀細(xì)胞在過敏性氣道炎癥中的作用[J];第三軍醫(yī)大學(xué)學(xué)報;2008年08期

7 錢迪;洪蘇玲;楊玉成;黃江菊;鄒偉;曾慶;;我國西部部分地區(qū)變應(yīng)性鼻炎流行病學(xué)抽樣調(diào)查[J];第三軍醫(yī)大學(xué)學(xué)報;2008年06期

8 韓德民;張羅;黃丹;武陽豐;董震;許庚;孔維佳;暴繼敏;周兵;汪審清;王德輝;王秋萍;;我國11個城市變應(yīng)性鼻炎自報患病率調(diào)查[J];中華耳鼻咽喉頭頸外科雜志;2007年05期

9 夏鳳云,張友芹,高晶;沈陽地區(qū)豚草及其花粉的調(diào)查[J];植物學(xué)通報;1984年04期

10 顧之燕;趙悹蘭;劉青;;花粉癥普查資料分析[J];中華耳鼻咽喉頭頸外科雜志;1982年03期

相關(guān)碩士學(xué)位論文 前1條

1 趙筱揚;昆明地區(qū)變應(yīng)性鼻炎的流行病學(xué)調(diào)查及分析[D];昆明醫(yī)科大學(xué);2013年

，

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