嗜酸性粒细胞性慢性鼻窦炎粘膜炎症与手术疗效的相关性

王成钢; 吴海鹰

嗜酸性粒细胞性慢性鼻窦炎粘膜炎症与手术疗效的相关性

王成钢¹,
吴海鹰²

1. 曲靖市第二人民医院耳鼻喉科
2. 昆明医科大学第二附属医院耳鼻喉科

基金项目:

基金：云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目 (2017FE467);

计量
- 文章访问数: 1755
- HTML全文浏览量: 582
- PDF下载量: 83
- 被引次数: 0
出版历程
- 收稿日期: 2017-10-24

The Relationship between the Inflammation of Mucosa and the Curative Effect of Eosinophilic Chronic Sinusitis

Wang Cheng Gang ¹,
Wu Hai Ying ²

Funds:

基金：云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目 (2017FE467);

摘要

摘要: 目的探讨嗜酸性粒细胞性慢性鼻窦炎患者的粘膜炎症和其手术疗效之间的关系.方法 2014年9月至2017年9月, 选取曲靖市第二人民医院收治的30例嗜酸性粒细胞性慢性鼻窦炎患者作为研究对象, 对其鼻窦组织石蜡标本行HE染色, 显微镜观察计算炎症细胞数目以及其中含有的嗜酸性粒细胞数目, 判定嗜酸性粒细胞的浸润程度, 对患者手术治疗效果评估, 分析嗜酸性粒细胞的浸润程度和临床分型之间的关系.结果 30例慢性鼻窦炎患者术后12周病变黏膜相关嗜酸性粒细胞的浸润程度为3级、4级所占百分比较手术前明显降低 (χ2=7.687 6, P=0.005 5) ;术后46周病变黏膜相关嗜酸性粒细胞的浸润程度为3级、4级所占百分比较手术前, 无显著差异性 (χ2=0.326 7, P=0.567 6) ;术后1012周病变黏膜相关嗜酸性粒细胞的浸润程度为3级、4级所占百分比对比于手术前明显降低 (χ2=13.484 2, P=0.000 2) .30例慢性鼻窦炎患者病变黏膜相关嗜酸性粒细胞浸润程度为1级的治疗有效率较浸润程度为3级、4级明显提升 (χ2=23.099 0、23.099 0, P=0.000 0、0.000 0) ;慢性鼻窦炎患者病变黏膜相关嗜酸性粒细胞浸润程度为2级的治疗有效率较浸润程度为3级、4级明显提升 (χ2=12.281 7、12.281 7, P=0.000 4、0.000 4) .临床分型为1型中, 浸润程度1级、浸润程度2级均有分布, 无浸润程度3级、浸润程度4级;临床分型为2型中, 浸润程度1级最多, 浸润程度2级、浸润程度3级、浸润程度4级均有分布;临床分型为3型中, 浸润程度1级最多, 浸润程度2级、浸润程度3级、浸润程度4级均有分布.浸润程度1级和2级的临床分型为2型所占百分比较浸润程度3级、4级, 数据没有出现显著差异性改变 (χ2=0.380 1、0.380 1和0.380 1、0.380 1, P=0.537 5、0.537 5和0.537 5、0.537 5) .结论嗜酸性粒细胞性慢性鼻窦炎患者的粘膜炎症和其手术疗效之间具有一定的相关性.
- 嗜酸性粒细胞 /
- 慢性鼻窦炎 /
- 粘膜炎症 /
- 手术疗效 /
Abstract: Objective To explore the relationship between the mucosal inflammation and the surgical efficacy of patients with eosinophilic chronic sinusitis. Me thods From September 2014 to September 2017, 30 patients with chronic eosinophils sinusitis were selected in our hospital. We colored the sinus tissue paraffin specimens by HE staining, calculated the number of inflammatory cells by microscope observation and the number of eosinophils contained, determined the eosinophil infiltration degree, evaluated the effect of surgical treatment, and analyzed the eosinophil infiltration degree and the relationship between the clinical classification.Re s ults The infiltration degree of the mucosa related eosinophilic granulocytes was significantly lower (χ2=7.6876, P =0.0055) after1-2 weeks after surgery for patients with chronic sinusitis. The degree of infiltration of the mucosa related eosinophilic granulocytes at 4 weeks and 6 weeks after surgery was 3 and 4. There was no significant difference before surgery (χ2=0.3267, P=0.5676) . The degree of infiltration of the mucosa related eosinophils in the 10-12 weeks after surgery was significantly lower than that in grade 3 and 4 (χ2=13.4842, P=0.0002) . In 30 patients with chronic sinusitis, the treatment efficiency of the mucosa associated eosinophilic granulocytic infiltration level was level 3 and level 4 (χ2= 23.0990, 23.0990, P= 0.0000, 0.0000) . The treatment efficiency of the lesion of the mucosa of patients with chronic sinusitis was level 2 and the level of infiltration was 3 and 4 (χ2=12.2817, 12.2817, P =0.0004, 0.0004) . In the clinical fractal type 1, the degree of infiltration level 1 and 2 was distributed, and the degree of infiltration level 3 and 4 was absent; In the clinical fractal type 2, the degree of infiltration level 1 was mostly observed and the degree of infiltration level 2, 3 and 4 was distributed; In the clinical fractal type 3, the degree of infiltration level 1 was mostly observed and the degree of infiltration level 2, 3 and 4 was distributed. The comparison between infiltration degree level 1 and level 2 of the total clinical classification and the type 2 percentage infiltration degree level 3 and level 4 was not significant (χ2=0.3801, 0.3801 and 0.3801, 0.3801, P=0.5375, 0.5375, 0.5375, 0.5375) . Conclusion There is a certain relationship between the mucosal inflammation and the curative effect of eosinophilic chronic sinusitis.
- Eosinophil /
- Chronic sinusitis /
- Mucosal inflammation /
- Curative effect /
- Relationship

HTML全文

参考文献(17)

[1]朱洪海, 朱晓远, 程根阳.鼻渊通窍颗粒对儿童慢性鼻窦炎鼻黏膜纤毛传输功能及炎性因子的影响[J].中国实验方剂学杂志, 2014, 20 (10) :188-191.
[2]	[2]OKANO M, KARIYA S, OHTA N, et al.Association and management of eosinophilic inflammation in upper and lower airways[J].Allergology International, 2015, 64 (2) :131-138.
[3]李华斌, 冯韶燕, 程岚.嗜酸粒细胞性慢性鼻窦炎的临床特点和治疗策略[J].临床耳鼻咽喉头颈外科杂志, 2016, 30 (3) :177-179.
[4]	[4]ENDO Y, HIRAHARA K, SHINODA K, et al.Human and mouse memory-type pathogenic Th2 (Tpath2) cells in airway inflammation[M].Tokyo:Springer Japan, 2016:401-415.
[5]李莉.慢性鼻-鼻窦炎鼻内镜鼻窦手术前后黏膜形态变化及相关性分析[J].蚌埠医学院学报, 2015, 40 (1) :80-82.
[6]刘业军, 张承宏, 刘建设, 等.吡酮莫特治疗对慢性鼻窦炎患者外周T淋巴细胞亚群, NK细胞活性以及炎症因子的影响[J].海南医学院学报, 2016, 22 (3) :306-309.
[7]	[7]AKDIS M, AKDIS C A.Mechanisms of allergen-specific immunotherapy:multiple suppressor factors at work in immune tolerance to allergens[J].Journal of Allergy and Clinical Immunology, 2014, 133 (3) :621-631.
[8]巴罗, 杜进涛, 蔡舜玉, 等.不同免疫表型鼻息肉中黏膜炎症模式与组织重塑特征[J].临床耳鼻咽喉头颈外科杂志, 2016, 30 (16) :1302-1307.
[9]	[9]VAN D E VEEN W, WIRZ O F, GLOBINSKA A, et al.Novel mechanisms in immune tolerance to allergens during natural allergen exposure and allergen-specific immunotherapy[J].Current Opinion in Immunology, 2017, 48 (10) :74-81.
[10]朱顺芳.影响慢性鼻-鼻窦炎鼻内镜手术预后因素Logistic回归分析[J].现代仪器与医疗, 2016, 22 (2) :034.
[11]	[11]AKDIS C A, AKDIS M.Mechanisms of allergen-specific immunotherapy and immune tolerance to allergens[J].World Allergy Organization Journal, 2015, 8 (1) :17.
[12]陈新野, 张春林, 洪海裕, 等.败丹黄灌洗液鼻腔灌洗对慢性鼻窦炎伴鼻息肉患者术后的临床疗效影响[J].中国中西医结合杂志, 2013, 33 (2) :180-185.
[13]	[13]KOTLYAR D S, SHUM M, HSIEH J, et al.Nonpulmonary allergic diseases and inflammatory bowel disease:a qualitative review[J].World Journal of Gastroenterology, 2014, 20 (32) :11023.
[14]	[14]FUJIEDA S, IZUHARA K.Regulation of upper airway inflammation facilitates comfortable breathing[J].Allergology International, 2015, 64 (2) :119-120.
[15]訾晓雪, 赵莉, 金鹏, 等.伴有嗅觉障碍的慢性鼻-鼻窦炎患者鼻内镜术后嗅觉及生活质量转归的研究[J].山东大学耳鼻喉眼学报, 2016, 30 (1) :21-25.
[16]	[16]PARAMASIVAN S, DRILLING A J, JARDELEZA C, et al.Methylglyoxal augmented manuka honey as a topical anti Staphylococcus aureus biofilm agent:safety and efficacy in an in vivo model[C]//International forum of allergy&rhinology, 2014, 4 (3) :187-195.
[17]程琳, 何志龙.鼻内镜下鼻窦手术同期行鼻中隔矫正术92例疗效分析[J].现代医药卫生, 2013, 29 (3) :415-417.

相关文章(20)

[1]	李玲华, 韩旭, 张雪琴, 华校琨, 李春玲. 三维直肠腔内超声结合耦合剂造影对肛周坏死性筋膜炎的手术指导价值, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20240322
[2]	朱琳玲, 王成钢, 杨红良, 温湘玲. 鼻窦扩大开放中鼻甲大部分切除联合神经分支阻断术在难治性鼻窦炎患者中的疗效, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20220919
[3]	蔡润茁, 曾令达, 李登辉, 朱丽明. 两性霉素B冲洗对难治性鼻窦炎鼻内镜术后嗜酸性粒细胞、上皮化时间的影响, 昆明医科大学学报.
[4]	孙春红, 姚建娜, 王嫚, 林欢, 王晓宁, 郭彩利. PDCA循环法在降低造血干细胞移植患者口腔粘膜炎发生率中的应用, 昆明医科大学学报.
[5]	王旭, 郭清华, 朱晓朴, 朱晓燕, 杨明. 鼻内镜手术治疗真菌球型鼻窦病变的效果, 昆明医科大学学报.
[6]	魏韩笑. 手术联合光动力疗法治疗颜面部基底细胞癌10例, 昆明医科大学学报.
[7]	白桦. 同步放化疗与序贯化放疗治疗Ⅲ期不能手术非小细胞肺癌的临床疗效, 昆明医科大学学报.
[8]	薛凤麟. Kimura病2例报道, 昆明医科大学学报.
[9]	吴志勇. 辅助化疗结合手术治疗非小细胞肺癌的临床观察, 昆明医科大学学报.
[10]	刘波. 嗜酸粒细胞性支气管炎与咳嗽变异性哮喘患者的气道炎症特征, 昆明医科大学学报.
[11]	. 颈前路手术治疗下颈椎骨折脱位疗效观察, 昆明医科大学学报.
[12]	. 云南白药在鼻内窥镜术围手术期止血的疗效观察, 昆明医科大学学报.
[13]	廖立凡. 单侧髁突切除对非手术侧髁突软骨细胞凋亡的影响, 昆明医科大学学报.
[14]	. 单侧髁突切除对非手术侧髁突软骨细胞凋亡的影响, 昆明医科大学学报.
[15]	黄韬. 胸膜纤维板剥脱治疗慢性脓胸73例手术体会, 昆明医科大学学报.
[16]	. 复发性额窦炎鼻内镜下经鼻丘径路再手术, 昆明医科大学学报.
[17]	王建平. 鼻内镜手术治疗真菌性上颌窦炎96例疗效分析, 昆明医科大学学报.
[18]	. 鼻内镜手术治疗真菌性上颌窦炎96例疗效分析, 昆明医科大学学报.
[19]	唐强. 慢性鼻－鼻窦炎功能性鼻窦内镜手术426例临床治疗分析, 昆明医科大学学报.
[20]	李晓明. 系统性淋巴结清扫在非小细胞肺癌手术中的应用, 昆明医科大学学报.