布地奈德对慢性鼻-鼻窦炎术后鼻黏膜组织重塑及转化生长因子β1表达的影响  

Effects of Budesonide on Tissue Remodeling and TGF-β1 Expression in Nasal Mucosa after Endoscopic Sinus Surgery for 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]中国人民解放军第九四医院耳鼻咽喉科,南昌330002

出　　处：《南昌大学学报（医学版）》2014年第3期1-5,9,共6页Journal of Nanchang University：Medical Sciences

基　　金：南京军区医学科技创新课题(09MA055)

摘　　要：目的观察布地奈德对不伴鼻息肉的慢性鼻-鼻窦炎(CRSsNP)术后黏膜组织重塑及转化生长因子-β1(TGF-β1)表达的影响。方法 30例行鼻内镜手术的CRSsNP患者术后按随机数字表法分为2组,20例术后应用布地奈德喷鼻(激素组),10例术后未使用糖皮质激素(对照组)。术后第3个月复查时取筛区黏膜标本。所有标本分别进行HE染色、Masson三色(Masson trichrome,MT)胶原染色及苦味酸-天狼星红染色,观察黏膜上皮损伤、基底膜增厚、细胞外基质(ECM)胶原沉积及成分等情况;免疫组织化学检测黏膜中TGF-β1的表达情况。结果激素组上皮细胞损伤比对照组明显减轻(P<0.05),基底膜厚度减少[(7.62±2.83)μm比(12.17±4.34)μm,P<0.01];激素组黏膜固有层内蓝色胶原所占面积百分比为(7.41±1.93)%,明显少于对照组的(18.54±6.37)%,(P<0.01),沉积的胶原以Ⅰ型胶原为主,Ⅲ型、Ⅳ型胶原较少;激素组鼻黏膜TGF-β1表达较对照组明显减少(138.78±5.24比165.58±7.62,P<0.01)。结论及时应用布地奈德能在一定程度上抑制CRSsNP术后鼻黏膜组织重塑,降低TGF-β1的表达可能是其中机制之一。Objective To explore the effects of budesonide on tissue remodeling and transfor-ming growth factor-β1（TGF-β1）expression in nasal mucosa after endoscopic sinus surgery（ESS） for chronic rhinosinusitis without nasal polyps（CRSsNP）.Methods Thirty patients who under-went ESS for CRSsNP were randomly treated with budesonide（glucocorticoid group,n=20）or without glucocorticoid（control group,n=10）.Specimens of nasal mucosa were collected 3 months after operation.Mucosal epithelium damage,basement membrane thickness,and collagen deposi-tion and types in extracellular matrix were observed by hematoxylin-eosin,Masson trichrome and picric acid-Sirius red staining,respectively.The expression of TGF-β1 was determined by immuno-histochemistry.Results Compared with control group,budesonide treatment led to significant decrea-ses in epithelial damage,basement membrane thickness [（7.62±2.83）μm vs （12.17±4.34）μm], percentage of blue collagen-stained area[（7.41±1.93）% vs （18.54±6.37）%],and expression of TGF-β1（138.78±5.24 vs 165.58±7.62）（P 〈0.05 or P 〈0.01）.The collagen deposited in ECM was mainly composed of type Ⅰcollagen.The content of type Ⅲ or Ⅳ collagen was lower than＆amp;nbsp;that of type Ⅰcollagen.Conclusion Timely application of budesonide can inhibit tissue remode-ling in nasal mucosa after ESS for CRSsNP.The mechanism of budesonide action may be partially mediated through reducing the expression of TGF-β1.

关 键 词：鼻窦炎 布地奈德 气道重塑 转化生长因子Β1 细胞外基质 TRANSFORMING growth factor-β1 

分 类 号：R765.4[医药卫生—耳鼻咽喉科]