摘要
目的 慢性鼻窦炎的难治性在于发病因素的复杂性,本研究拟探讨细菌生物膜、变态反应、主要炎性细胞因子与难治性慢性鼻窦炎的相关性.方法 采用视觉模拟量表评分和鼻内镜检查评分的方法 ,从340例首次接受内镜鼻窦手术和规范药物治疗1年以上的慢性鼻窦炎患者中,选择19例治疗无效者、6例临床治愈者分别作为实验组和对照组,通过电镜扫描、酶联免疫吸附法分别检测两组病例筛窦黏膜表面细菌生物膜的形成和筛窦黏膜组织中特异性IgE、白细胞介素（interleukin,IL）-4、IL-5、IL-6、IL-8的含量,统计分析比较组间差异.数据分析用SPSS13.0统计软件处理.结果 ①筛窦黏膜表而细菌生物膜：实验组有19例除上皮细胞结构破坏、纤毛脱落等病变以外,全部发现细菌生物膜形成,而对照组6例上皮细胞结构完整,纤毛整齐,未发现细菌生物膜形成,组间细菌生物膜检出率差异具有统计学意义（P〈0.01）.②特异性IgE：实验组有9例筛窦黏膜组织检测到特异性IgE,而对照组6例均未检测到特异性IgE,组间差异有统计学意义（P〈0.05）.③IL：实验组仪有2例标本中检测到IL-8含量升高,实验组和对照组其他病例4种IL含量均在王常参考值以下而无法检出.实验组检测到IL的病例数分别为：IL-4 7例、IL-5 14例、IL-6 15例、IL-8 12例,对照组检测到的病例数分别为：IL-4 1例、IL-5 5例、IL-6 5例、IL-8 5例,组间检出率差异无统计学意义（P值均〉0.05）.结论 细菌生物膜、变应性炎性反应是导致难治性慢性鼻窦炎的重要相关因素之一.
Objective To explore the relationship between the bacterial biofilm, allergy,inflammatory cytokines and refractory rhinosinusitis. Method According to the assessment of symptom by visual analogue scale and nasal endoscopy by Lund-Kennedy system, 19 patients with persistent chronic rhinosinusitis and 6 patients with curative chronic rhinosinusitis were recruited from 340 chronic rhinosinusitis patients underwent functional endoscopic sinus surgery for the first time and received standard medication postoperatively. These cases were divided into the study group and the control group respectively.Electron microscope scanning and enzyme linked immunosorbent assay were used to observe the bacterial biofilm formation on ethmoid sinus mucosal surface and detect the concentration of specific IgE and interleukin （IL） 4, IL-5, IL-6, and IL-8 in ethmoid sinus mucosal tissue. Then the differences between the group were all found biofilm formation in ethmoid sinus, besides the damage of epithelial cells and cilia. Six cases from the control group were found no biofilm, with the integrity of epithelial cells and cilia. Statistical Specific IgE： specific IgE was detected in nine cases from the study group and was not found in any case all detected under normal value both in the study group and the control group, except for only 2 cases from the study group with higher IL-8 concentration. Positive reaction to IL was detected as follows： IL-4 （7cases）, IL-5 （14 cases）, IL-6 （15 cases）, and IL-8 （12 cases） in the study group; IL-4 （1 case）, IL-5 （5 cases）, IL-6 （5 cases）, and IL-8 （5 cases） in control group. No difference in IL detection rate was found between the two groups （P 〉 0.05）. Conclusion Bacterial biofilm and allergic inflammation are important factors resulting into refractory chronic rhinosinusitis.
出处
《中华耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2010年第12期1003-1007,共5页
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
基金
广东省自然科学基金（8451008901000862）
