实验性鼻窦炎嗅黏膜形态学与ATP酶变化的研究  

Olfactory mucosal morphology and ATPase change in experimental sinusitis

作　　者：王斌[1] 李勇[1] 曹晓林 金卫东 刘锋 WANG Bin;LI Yong;CAO Xiao-lin;JIN Wei-dong;LIU Feng(ENT&HN Surgery Department,Hangzhou First People’s Hospital Affiliated with Zhejiang University School of Medicine,Hangzhou 310006;ENT&HN Surgery Department,Naval Military Medical University Affiliate Changhai Hospital,Shanghai 200433,China)

机构地区：[1]浙江大学医学院附属杭州市第一人民医院耳鼻咽喉头颈外科,浙江杭州310006 [2]海军军医大学附属长海医院耳鼻咽喉头颈外科,上海200433

出　　处：《健康研究》2019年第4期424-427,共4页Health Research

基　　金：杭州市卫生科技计划项目(2016A01)

摘　　要：目的探讨实验性鼻窦炎中嗅黏膜形态学及嗅黏膜中Na^+-K^+-ATP酶表达的变化。方法选用新西兰大白兔50只随机分为正常对照组、鼻窦炎组和手术处理组,鼻窦炎组和手术处理组构建鼻窦炎模型,手术处理组施行上颌窦开放术后观察嗅黏膜恢复情况。采用HE染色光学显微镜、扫描电镜、透射电镜观察嗅黏膜形态变化,采用化学比色法测量嗅黏膜ATP酶含量。结果炎症状态下的兔嗅黏膜随病程迁延,上皮层纤毛脱落增加、炎细胞浸润、鳞状上皮化生、上皮坏死,固有层腺体化生、减少、纤维化;透射电镜下,Na^+-K^+-ATP酶的颗粒变细小、颜色变淡甚至消失。内窥镜鼻窦手术后,黏膜上皮层和固有层均有不同程度的恢复;Na^+-K^+-ATP酶颗粒变粗大、颜色变深。手术处理组的ATP酶含量(0.229±0.100μmolPi/mg)与鼻窦炎组(0.124±0.033μmolPi/mg)比较,差异有统计学意义(P<0.05);正常对照组的ATP酶含量(0.248±0.082μmolPi/mg)与手术处理组比较,差异无统计学意义(P>0.05)。结论炎症状态使嗅粘膜中Na^+-K^+-ATP酶的表达降低可能是导致嗅觉障碍发生的原因之一。Objective To examine the changes of morphology and expression of Na^+-K^+-ATP of olfactory mucosa in experimental sinusitis.Methods Firstly,50 New Zealand white rabbits were randomly divided into three groups:normal control group,sinusitis group and surgical treatment group.Establishment of sinusitis model in sinusitis group and operation group.Next,the surgical treatment group were subjected to maxillary sinus opening and the recovery of olfactory mucosa was followed-up.The morphological changes of olfactory mucus in the operation group were observed with HE staining microscope,scanning electron microscope and transmission electron microscope.The content of ATP in olfactory mucosa was measured by chemical colorimetry.Results With the prolongation of the course of the disease,the cilia of the epithelial layer of the olfactory mucosa in the inflammatory state increased,inflammatory cells infiltrated,squamous epithelium metaplasia,epithelial necrosis,glandular metaplasia,reduction and fibrosis in lamina propria.Under trans-mission electron microscope,the particles of Na^+-K^+-ATP enzyme became finer,the color became lighter and even disappeared.After endoscopic sinus surgery,the mucosal epithelium and lamina propria were recovered to different degrees,and the Na^+-K^+-ATP enzyme particles became thicker and darker.The content of ATP enzyme(0.229±0.100μmolPi/mg)in the operation group was significantly higher than that of the sinusitis group(0.124±0.033μmolPi/mg).The difference was statistically significant(P<0.05).No significant difference was found between the control group(0.248±0.082μmolPi/mg)and the operation group in the content of ATP enzyme(P>0.05).Conclusions The decreased expression of Na^+-K^+-ATP enzyme in olfactory mucosa may be one of the causes of olfactory dysfunction.

关 键 词：鼻窦炎 实验性 嗅黏膜 NA^+-K^+-ATP酶 

分 类 号：R76[医药卫生—耳鼻咽喉科]