{"title":"布地奈德鼻冲洗对慢性鼻窦炎患者内镜鼻窦手术后下丘脑-垂体-肾上腺轴的影响：一项前瞻性研究。","authors":"Jesada Kanjanaumporn, Sorranut Thaweboon, Songklot Aeumjaturapat, Kornkiat Snidvongs, Supinda Chusakul, Kachorn Seresirikachorn, Lalita Prathanee","doi":"10.12932/AP-121124-1968","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Corticosteroids added to high volume saline nasal irrigation have been introduced as a more effective method of delivering corticosteroids to the sinuses than nasal sprays. However, information regarding the effect of this intervention on the hypothalamic-pituitary-adrenal (HPA) axis is still limited.</p><p><strong>Objective: </strong>To evaluate the safety of long-term corticosteroid (6 months) nasal irrigation in patients with chronic rhinosinusitis (CRS) post endoscopic sinus surgery.</p><p><strong>Methods: </strong>Seventeen patients with CRS were included. After undergoing endoscopic sinus surgery, the patients were prescribed budesonide nasal irrigations (250 ml via squeeze bottle) twice daily (1 mg/day) for six months. The serum morning cortisol levels of these patients were then evaluated at 3 and 6 months post-operatively.</p><p><strong>Results: </strong>Median serum morning cortisol levels were 10.5 mcg% at pre-operative baseline; 10.3 mcg% at 3 months; and 11.2 mcg% at 6 months on post-operative follow-up. There were no significant changes in the serum morning cortisol levels (P value = 0.71 and 0.63 respectively). Three of 17 patients (17.65%) had mildly abnormal serum morning cortisol levels (4, 4.3 and 4.9 mcg%) at 3 months. However, these levels were within a normal range at 6 months.</p><p><strong>Conclusions: </strong>Serum morning cortisol levels were not significantly changed after usage of budesonide nasal irrigation for 6 months.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effect of budesonide nasal irrigation on Hypothalamic-Pituitary-Adrenal Axis in patients with chronic rhinosinusitis post endoscopic sinus surgery: A prospective study.\",\"authors\":\"Jesada Kanjanaumporn, Sorranut Thaweboon, Songklot Aeumjaturapat, Kornkiat Snidvongs, Supinda Chusakul, Kachorn Seresirikachorn, Lalita Prathanee\",\"doi\":\"10.12932/AP-121124-1968\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Corticosteroids added to high volume saline nasal irrigation have been introduced as a more effective method of delivering corticosteroids to the sinuses than nasal sprays. 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Three of 17 patients (17.65%) had mildly abnormal serum morning cortisol levels (4, 4.3 and 4.9 mcg%) at 3 months. 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引用次数: 0
摘要
背景：在高容量生理盐水鼻腔冲洗中加入皮质类固醇是一种比鼻腔喷雾剂更有效的将皮质类固醇输送到鼻窦的方法。然而，关于这种干预对下丘脑-垂体-肾上腺轴（HPA）的影响的信息仍然有限。目的：评价内镜鼻窦手术后慢性鼻窦炎（CRS）患者长期使用皮质类固醇（6个月）鼻腔冲洗的安全性。方法：选取17例CRS患者。鼻窦内窥镜手术后，患者给予布地奈德鼻冲洗（250 ml，挤压瓶），每日2次（1 mg/天），持续6个月。然后在术后3个月和6个月评估这些患者的血清早晨皮质醇水平。结果：术前基线时血清早晨皮质醇水平中位数为10.5 mcg%；3个月时10.3 MCG %；术后随访6个月时为11.2%。晨间血清皮质醇水平无显著变化（P值分别为0.71和0.63）。17例患者中有3例（17.65%）在3个月时血清早晨皮质醇水平轻度异常（4,4.3和4.9 mcg%）。然而，这些水平在6个月时都在正常范围内。结论：布地奈德鼻冲洗6个月后血清皮质醇水平无明显变化。
Effect of budesonide nasal irrigation on Hypothalamic-Pituitary-Adrenal Axis in patients with chronic rhinosinusitis post endoscopic sinus surgery: A prospective study.
Background: Corticosteroids added to high volume saline nasal irrigation have been introduced as a more effective method of delivering corticosteroids to the sinuses than nasal sprays. However, information regarding the effect of this intervention on the hypothalamic-pituitary-adrenal (HPA) axis is still limited.
Objective: To evaluate the safety of long-term corticosteroid (6 months) nasal irrigation in patients with chronic rhinosinusitis (CRS) post endoscopic sinus surgery.
Methods: Seventeen patients with CRS were included. After undergoing endoscopic sinus surgery, the patients were prescribed budesonide nasal irrigations (250 ml via squeeze bottle) twice daily (1 mg/day) for six months. The serum morning cortisol levels of these patients were then evaluated at 3 and 6 months post-operatively.
Results: Median serum morning cortisol levels were 10.5 mcg% at pre-operative baseline; 10.3 mcg% at 3 months; and 11.2 mcg% at 6 months on post-operative follow-up. There were no significant changes in the serum morning cortisol levels (P value = 0.71 and 0.63 respectively). Three of 17 patients (17.65%) had mildly abnormal serum morning cortisol levels (4, 4.3 and 4.9 mcg%) at 3 months. However, these levels were within a normal range at 6 months.
Conclusions: Serum morning cortisol levels were not significantly changed after usage of budesonide nasal irrigation for 6 months.
期刊介绍：
The Asian Pacific Journal of Allergy and Immunology (APJAI) is an online open access journal with the recent impact factor (2018) 1.747
APJAI published 4 times per annum (March, June, September, December). Four issues constitute one volume.
APJAI publishes original research articles of basic science, clinical science and reviews on various aspects of allergy and immunology. This journal is an official journal of and published by the Allergy, Asthma and Immunology Association, Thailand.
The scopes include mechanism, pathogenesis, host-pathogen interaction, host-environment interaction, allergic diseases, immune-mediated diseases, epidemiology, diagnosis, treatment and prevention, immunotherapy, and vaccine. All papers are published in English and are refereed to international standards.
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