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      标题:炎症介质在不同表型鼻息肉及慢性鼻窦炎患者鼻黏膜中的表达及意义
      作者:秦奋,吴小松    (重庆市急救医疗中心耳鼻咽喉科,重庆 400014)
      卷次: 2018年29卷19期
      【摘要】 目的 分析白介素 1β (IL-1β)、肿瘤坏死因子α (TNF-α)、核转录因子κB (NF-κB)、环氧合酶 2(COX-2)及一氧化氮合酶2 (NOS-2)在嗜酸性鼻息肉、嗜中性鼻息肉及慢性鼻窦炎患者鼻黏膜中的表达,探讨其在鼻息肉发生发展进程中的作用。方法 收集重庆市急救医疗中心耳鼻咽喉科2014年5月至2016年5月收治的慢性鼻窦炎患者的鼻黏膜组织共60例,其中嗜酸性鼻息肉患者20例(A组)、嗜中性鼻息肉患者20例(B组)、无鼻息肉患者20例(C组)。采用免疫组化方法检测各组鼻黏膜组织血管内皮细胞、上皮细胞、基质细胞及腺细胞中 IL-1β、TNF-α、COX-2、NOS-2及NF-κB的表达。结果 A、B两组患者中所有类型细胞的 IL-1β、TNF-α、COX-2、NOS-2及NF-κB的表达均高于C组,差异均有统计学意义(P<0.05);A组中,TNF-α在所有类型细胞中高表达,相比于基质细胞,IL-1β在血管内皮细胞、腺细胞及上皮细胞中高表达,相比于血管内皮细胞和腺细胞,NF-κB在基质细胞和上皮细胞中高表达,相比于血管内皮细胞和上皮细胞,COX-2在腺细胞及基质细胞中高表达,相比于上皮细胞和腺细胞,NOS-2在血管内皮细胞和基质细胞中高表达,以上各项指标比较差异均有统计学意义(P<0.05);与A组和C组比较,B组患者中的COX-2在上皮细胞和血管内皮细胞中高表达,NOS-2在腺细胞和上皮细胞中高表达,差异均有统计学意义(P<0.05);与C组比较,A、B两组患者中所有指标均在血管内皮细胞中有最强的表达,差异均有统计学意义(P<0.05)。结论 炎性标志物参与了嗜酸性及嗜中性鼻息肉病理过程,血管内皮细胞缺陷在鼻息肉发展过程中扮演着重要的作用。
      【关键词】 鼻息肉;嗜酸性;嗜中性;炎症介质
      【中图分类号】 R765.4+1 【文献标识码】 A 【文章编号】 1003—6350(2018)19—2678—04
Expression and significance of inflammatory mediators in nasal mucosa of patients with different phenotypes ofnasal polyps and chronic rhinosinusitis. QIN Fen, WU Xiao-song. Department of Otolaryngology, Chongqing EmergencyMedical Center, Chongqing 400014, CHINA
      【Abstract】 Objective To analyze interleukin-1β (IL-1β), tumor necrosis factor α (TNF-α), nuclear factor-κB(NF-κB), cyclooxygenase 2 (COX-2), and nitric oxide synthase 2 (NOS-2) in the nasal mucosa of patients with eosino-philic or neutrophilic polyps and chronic sinusitis, and to explore the role of these factors in the development of nasalpolyps. Methods A total of 60 specimens of nasal mucosa in patients with chronic sinusitis were collected, who admit-ted to the Department of Otolaryngology in Chongqing Emergency Medical Center from May 2014 to May 2016, includ-ing 20 patients with eosinophilic nasal polyps (group A), 20 patients with neutrophilic nasal polyps (group B) and 20 pa-tients without nasal polyps (group C). Immumohistochemical method was used to detect the expressions of IL-1 β,TNF-α, COX-2, NOS-2 and NF-κB in vascular endothelial cells, epithelial cells, stromal cells and glandular cells of na-sal mucosa. Results The expression levels of IL-1β, TNF-α, COX-2, NOS-2 and NF-κB in all types of cells in groupA and group B were significantly higher than those in group C (P<0.05). In group A, there were stronger expression ofTNF-α in all cellular types, and IL-1β in endothelial cells, glandular cells and epithelial cells compared with stromalcells, and NF-κB in stromal cells and epithelial cells compared to vascular endothelial cells and glandular cells, andCOX-2 in glandular cells and stromal cells compared to vascular endothelial cells and epithelial cells, and NOS-2 in vas-cular endothelial and stromal cells compared to epithelial cells and glandular cells; the above differences among media-tors were statistically significant (P<0.05). Compared with group A and group C, there were stronger expression ofCOX-2 in epithelial cells and vascular endothelial cells, and NOS-2 in glandular cells and epithelial cells in group B,and all differences were statistically significant (P<0.05). Compared with group C, all the mediators in both group A andgroup B had the strongest expression in vascular endothelial cells (P<0.05). Conclusion Inflammatory mediators areinvolved in pathogenesis of both eosinophilic and neutrophilic polyps. Vascular endothelial defects play an importantrole in the development of nasal polyps.
      【Key words】 Nasal polyp; Eosinophil; Neutrophil; Inflammatory mediators·论 著·
      基金项目:重庆市计划和生育委员会基金(编号:2015XMSB0001085)

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