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大环内酯类抗菌药物治疗慢性鼻-鼻窦炎的机制及应用
张涛,唐海红,郑宏良*
0
(海军军医大学(第二军医大学)长海医院耳鼻咽喉头颈外科, 上海 200433
*通信作者)
摘要:
慢性鼻-鼻窦炎是一种鼻腔和鼻窦的慢性炎症性疾病,病理表现为各类炎性介质诱发的黏液过度分泌和黏膜炎症。大环内酯类抗菌药物因其具有抗炎及免疫调节作用而被广泛应用于慢性鼻-鼻窦炎的临床治疗。小剂量、长期口服大环内酯类抗菌药物的治疗方案,对不伴鼻息肉、无嗜酸粒细胞增多、免疫球蛋白E水平正常的非变应性慢性鼻-鼻窦炎疗效较好,已被列入慢性鼻-鼻窦炎诊断和治疗指南。本文就大环内酯类抗菌药物在治疗慢性鼻-鼻窦炎的机制、药理特性、临床应用方面的新进展进行综述。
关键词:  慢性鼻-鼻窦炎  大环内酯类  治疗结果  抗菌药
DOI:10.16781/j.0258-879x.2018.12.1364
投稿时间:2018-04-03修订日期:2018-07-09
基金项目:
Mechanism and application of macrolide antibiotics in treatment of chronic rhinosinusitis
ZHANG Tao,TANG Hai-hong,ZHENG Hong-liang*
(Department of Otorhinolaryngology/Head and Neck Surgery, Changhai Hospital, Navy Medical University(Second Military Medical University), Shanghai 200433, China
*Corresponding author)
Abstract:
Chronic rhinosinusitis (CRS) is a chronic inflammatory disease of the nasal cavity and paranasal sinuses, and the pathological manifestations include mucus hypersecretion and mucosal inflammation induced by various inflammatory mediators. Macrolide antibiotics are widely used in the clinical treatment of CRS due to the anti-inflammatory and immunomodulatory effects. A low-dose, long-term oral macrolide antimicrobial method is recommended, and it is effective for non-allergic CRS without nasal polyps or eosinophilia, or with normal immunoglobulin E level. This paper reviews the mechanism, pharmacological characteristics and clinical application of macrolide antibiotics for CRS.
Key words:  chronic rhinosinusitis  macrolides  treatment outcome  anti-bacterial agents