糖皮质激素受体蛋白在OSAHS患儿腺样体和扁桃体中的表达及临床意义  

The protein expression of glucocorticoid receptor(GR) in adenoid and tonsil and its clinical significance

作　　者：周珍[1] 倪海峰[2] 周荣璟 汤建国[4] 李勇[2] 江波[2] 

机构地区：[1]杭州市肿瘤医院耳鼻咽喉头颈外科,310002 [2]杭州市第一人民医院耳鼻咽喉头颈外科 [3]杭州市肿瘤医院病理科,310002 [4]浙江大学医学院附属邵逸夫医院耳鼻咽喉头颈外科

出　　处：《浙江医学》2016年第2期84-88,共5页Zhejiang Medical Journal

基　　金：浙江省医药卫生一般研究计划项目(2015KYB294)

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿腺样体及扁桃体组织中糖皮质激素受体(GR)α和β蛋白的表达情况及临床意义。方法收集103例中重度OSAHS患儿的腺样体组织,69例中重度OSAHS息儿的扁桃体组织,20例成人慢性鼻咽炎鼻咽部组织,13例成人慢性扁桃体炎扁桃体组织,应用免疫组化SP法检测腺样体、扁桃体和鼻咽部组织中GRα和GR口蛋白的表达情况,并作比较分析。结果所有的腺样体、扁桃体、鼻咽部组织中均存在不同程度的GRα和GRβ蛋白表达,在腺样体组织中GRα呈高表达,在扁桃体、鼻咽部组织中GRβ呈高表达。在伴或不伴过敏性鼻炎,伴或不伴慢性鼻窦炎,伴或不伴分泌性中耳炎的OSAHS患儿间比较,其腺样体和扁桃体组织中GRα、GRβ蛋白表达及GRα/GRβ均无统计学差异(均P>0.05)。中、重度OSAHS患儿间比较,腺样体、扁桃体组织GRα、GRβ蛋白表达及GRα/GRβ均无统计学差异(均P>0.05)。Ⅱ、Ⅲ度扁桃体肥大的OSAHS患儿间比较,扁桃体组织GRα、GRβ蛋白表达及GRα/GRβ均无统计学差异(均P>0.05)。结论OSAHS患儿的腺样体组织对糖皮质激素(GC)的敏感性优于扁桃体组织,不同缺氧严重程度患儿间比较,激素受体表达无统计学差异,GC在OSAHS患儿的作用有待深入研究。Objective The aim of this study to determine the protein expression of glucocorticoid receptors （GR） α and β in tonsil and adenoid tissues of the children. Methods Tissues were collected from patients （103 cases of adenoid tissue of children with moderate and severe OSAHS and 69 cases tonsil tissue of children with moderate and severe OSAHS, as well as 13 cases of tonsil tissue of adult with chronic tonsillitis and 20 cases of nasopharyngeal mucous membrane with chronic pharyngitis）, which were analyzed with immunohistochemcal SP method to detect the protein expression of glucocorticoid receptors（GR） α and . Results The protein expression in different degrees of GRα and GR β in the tissues of adenoid, tonsil and nasopharyngeal mucous membrane were observed. GR αshowed a high expression in adenoid tissue, and GR β showed a high expression in tonsil and nasopharyngeal tissues. No significant difference （P 〉0.05） was showed between expression of GR α, GRβ and GR α/GR β in tissues of adenoid and tonsil of children with OSAHS and that in tissues of adenoid and tonsil of children with OSAHS （ with or without allergic rhinitis, with or without chronic rhinosinositis, as well as with or without secretory otitis media）. Also no significant difference （P 〉0.05） was found in expression of GR α, GR β and GR α/GR β between tissues of adenoid of children with moderate OSAHS and that of adenoid of children with severe OSAHS, and no significant difference （P 〉0.05） was found in expression of GR α, GR β and GR α/GR βbetween tissues of Ⅱ, Ⅲ tonsil hypertrophyl of children with OSAHS. Conclusion The adenoid tissues of children with OSAHS sensitivity to glucocorticoid （GC） is superior to the tonsil tissues, severity of hypoxia and the expression of hormone receptors in children with no statistical difference, So the effect of glucocorticoid treatment of adenoid-hypertrophy of children be worthy of being further studied.

关 键 词：糖皮质激素受体 腺样体 扁桃体 阻塞性睡眠呼吸暂停低通气综合征 

分 类 号：R766[医药卫生—耳鼻咽喉科]