不伴鼻息肉的慢性鼻-鼻窦炎鼻黏膜组织重塑研究  

Nasal mucosa remodeling in chronic rhinosinusitis without nasal polyps

作　　者：李晓华[1] 詹志荣[1] 孙建设[1] 曾斌[1] 薛艳平[1] 王诗琦[1] 

机构地区：[1]解放军第九四医院耳鼻咽喉科,南昌330002

出　　处：《临床耳鼻咽喉头颈外科杂志》2013年第20期1110-1113,1117,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：南京军区医学科技创新课题项目(No:09MA055)

摘　　要：目的:观察慢性鼻-鼻窦炎不伴鼻息肉(CRSsNP)黏膜组织重塑的特点。方法:收集30例CRSsNP患者和10例对照组的钩突黏膜组织,分别进行苏木精-伊红染色、Masson三色胶原染色、阿辛蓝-过典酸-希夫染色及苦味酸-天狼星红染色,观察黏膜上皮损伤、杯状细胞化生、基膜增厚、细胞外基质胶原沉积、腺体增生及胶原组成等情况。结果:①CRSsNP组上皮细胞损伤1级、2级和3级均比对照组明显增多(P<0.01或P<0.05),而损伤0级比对照组明显减少(P<0.01)。②黏膜下固有层黏液腺增生明显,分泌旺盛,上皮层杯状细胞计数较对照组明显增多(P<0.01)。③黏膜细胞外基质胶原沉积较对照组明显增多,基膜明显增厚(P<0.01)。④胶原沉积以Ⅰ型胶原为主,Ⅲ型、Ⅳ型胶原较少。结论:CRSsNP存在明显的鼻黏膜组织重塑,表现为上皮细胞损伤,细胞外基质胶原沉积、基膜增厚、杯状细胞和黏液腺增生。Objective：To explore the feature of nasal mucosa remodeling in chronic rhinosinusitis without nasal polyps（CRSsNP）. Method： Histological specimens from 30 selected patients with CRSsNP who underwent endo-scopic sinus surgery and 10 control subjects were studied. The paraffin sections were stained with hematoxylin-eosin（HE）, alcian blue-periodic acid-Schiff（AB-PAS）, Masson trichrome（MT） and Picric acid-Sirius red. The dam- age of epithelium, goblet cells and gland hyperplasia, deposition of collagen in extracellular matrix, the thickness of basement membrane and the type of collagen were observed respectively. Result ： Grade 0, Grade 1, Grade2 and Grade 3 of epithelial damage were significantly different in the CRSsNP group when compared with the control group（P〈0. 01 or P〈0.05）. Evident mucus gland hyperplasia and collagen deposition in extracellular matrix were observed in CRSsNP group（P〈0.01）. The number of goblet cells and the thickness of basement membrane were increased obviously in CRSsNP group（P〈0.01）. The collagen deposited in extracellular matrix was mainly composed of collagen type I . Collagen type III and collagen type IV was much less than collagen type I. Conclusion： The nasal mucosa remodeling was observed in CRSsNP group and was characterized by epithelial damage, basement membrane thickening, deposition of collagen in extracellular matrix, goblet cells and mucus gland hyperplasia.

关 键 词：鼻窦炎 鼻黏膜 气道重塑 上皮损伤 细胞外基质 

分 类 号：R765.4[医药卫生—耳鼻咽喉科]