Kartagener综合征鼻粘膜纤毛超微结构观察  

Observation of nasal mucosal cilia ultrastructure of Kartagener′s syndrome

作　　者：周兵[1] 官颖鹏[2] 刘淑红[3] 孙建军[2] 张罗[4] 韩德民[4] 

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉科,北京100730 [2]解放军海军总医院电镜室 [3]解放军军事医学科学院 [4]北京市耳鼻咽喉科研究所

出　　处：《中华耳鼻咽喉科杂志》2001年第5期323-325,T002,共4页Chinese Journal of Otorhinolaryngology

摘　　要：目的　报告Kartagener综合征鼻粘膜纤毛超微结构观察及 2例治疗结果。方法　报告 2例患者实施鼻内窥镜手术治疗 ,其中例 1取下鼻甲粘膜做扫描和透射电镜检查并随访 2年。结果　 2例患者表现为全内脏转位、慢性鼻窦炎鼻息肉及支气管炎 ;例 1扫描电镜观察纤毛表面形态基本正常 ;透射电镜观察纤毛“9+2”型结构尚正常 ,但各纤毛中心双微管排列方向紊乱 ;纤毛外动力臂存在 ,内动力臂缺失。例 1术后 1年 ,鼻窦炎鼻息肉复发。结论　先天性纤毛结构异常而导致的鼻窦粘液纤毛清除系统机能障碍是慢性鼻窦炎鼻息肉的病因和手术预后不良的原因之一 ,临床应予以重视。Objective To report the ultrastructure of nasal mucosal cilia of Kartagener′s syndrome and the operative results of 2 cases. Methods Both two cases were underwent endoscopic sinus surgery. Transmission and scanning electron microscopic examinations of nasal mucosa for case 1 were performed. Results All 2 cases presented situs inversus, chronic paranasal sinusitis and bronchiectasis. The electron microscopic examination showed that the shape of nasal cilia and '9+2' structure were normal, but the lack of inner dynein arm of cilia and confused arrangement of central pair of microtubules were confirmed. The recurrent of nasal polyps after 1-year follow-up was observed in case 1. Conclusions The disturbance of mucociliary clearance due to congenital ciliary structure defect might be the cause of chronic sinusitis and polyps, which might be one of reasons for poor prognosis after operation and we should pay more close attention.

关 键 词：卡塔格内综合征 电子显策镜检查 纤毛 鼻粘膜 超微结构 KARTAGENER综合征 鼻窦炎 

分 类 号：R765.02[医药卫生—耳鼻咽喉科]