摘要
目的:探讨糖皮质激素受体GRα/GRβ在慢性鼻-鼻窦炎治疗中的作用。方法:本研究共纳入2013年5月至2015年5月在上海交通大学医学院附属瑞金医院耳鼻咽喉科行鼻内镜手术治疗的慢性鼻-鼻窦炎患者150例,根据治疗效果分为有效组和无效组,通过免疫组织化学方法检测糖皮质激素受体GRα和GRβ在慢性鼻-鼻窦炎鼻息肉组织中的表达情况,同时选取无鼻-鼻窦炎及变应性疾病史患者中鼻甲黏膜作为阴性对照。分析GRα和GRβ表达水平与Lund and Kennedy内镜评分和生活质量评价的相关性。结果:在有效组、无效组和对照组的鼻黏膜(鼻息肉)中均有较高程度的GRα阳性细胞的表达,各组间的GRα积分无统计学意义;另外,有效组和无效组的GRβ积分均明显高于对照组,有效组GRβ积分明显低于无效组,两两比较,其差异均具有统计学意义(P<0.01)。相关性分析显示,将150例患者GRα的表达与Lund and Kennedy内镜评分无明显相关性,而GRβ的表达与Lund and Kennedy内镜评分呈现正相关。另外,GRα的表达与术后VAS评分、SNOT-20评分及SF-36评分之间无明显的相关性,而GRβ的表达与术后VAS评分和SNOT-20评分均呈正相关,而与术后SF-36评分无明显相关性。结论:GRβ的高表达可能是导致慢性鼻-鼻窦炎患者临床疗效不佳的重要因素。
Objective ：To investigate clinical effects of glucocorticoid receptors （GRct/GRβ） in the treatment of chronic rhinosinusitis, nethods：A total of 150 patiens with chronic rhinosinusitis who underwent nasal endoscopic surgery were enrolled in this study from May 2013 to May 2015 at our hospital. According to the therapeutic efficacy, the patients were divided into two groups：effective group and ineffective group,the expression of GRα/GRβ in nasal polyps tissue in patients with chronic rhinosinusitis was examined by immunohistochemistry,and middle turbinate mucosa in patients without nasal sinusitis and allergic diseases was used as a negative control. The correlation of GRα/GRβ expression with Lund and Kennedy score and quality of life was further analyzed. Results：There was a high level of GRα expression in all three groups,but no significant difference was found among the group,and the expression of GRβ in both effective group and ineffective group were significantly higher than that in the control group （ P 〈 0.01 ）. In addition,the expression of GRβ in effective group was significantly lower than that of the ineffective group （ P 〈 0.01 ）. Correlation analysis showed that there was no significant correlation between the expression of GRαand Lund and Kennedy score,while the expression of GR was positively correlated with Lund and Kennedy score. Additionally, there were no correlations between GRct expression with VAS score, SNOT-20 scores and SF-36 scores,and GRβ expression was positively correlated with VAS score and SNOT-20 score,but no with SF-36 score. Conclusion：The high expression of GRβ may be the main cause of the poor prognosis for patients with chronic rhinosinusitis after nasal endoscopic surgery.
出处
《川北医学院学报》
CAS
2016年第6期824-827,共4页
Journal of North Sichuan Medical College
