鼻用激素对鼻息肉组织中IL-5、GM-CSF的影响及意义

发布时间：2018-03-17 11:30

  本文选题：鼻息肉　切入点：IL-5　出处：《贵州医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:通过研究鼻息肉患者应用丙酸氟替卡松鼻喷剂治疗前后及正常下鼻甲组织中嗜酸性粒细胞浸润程度、IL-5(白细胞介素-5)、GM-CSF(粒细胞-巨噬细胞集落刺激因子)表达的差异性,了解鼻息肉形成中嗜酸性粒细胞浸润程度与IL-5、GM-CSF表达的作用之间的关系,及鼻用激素对鼻息肉组织的影响,进一步揭示鼻用糖皮质激素治疗鼻息肉的作用机制及其在临床中的应用意义。方法:采用免疫组化和计算机图像定量分析法,检测应用丙酸氟替卡松鼻喷剂前后鼻息肉组织及正常下鼻甲组织中IL-5和GM-CSF的表达;采用HE染色法检测应用丙酸氟替卡松鼻喷剂前后鼻息肉组织及正常下鼻甲组织中嗜酸性粒细胞浸润程度;把每个鼻息肉组织测得的IL-5、GM-CSF(包括应用丙酸氟替卡松鼻喷剂前后)分别与其嗜酸性粒细胞浸润程度绘制成散点图进行相关性分析。结果:1.鼻息肉组织中IL-5、GM-CSF的表达和嗜酸性粒细胞侵润程度均增高,与正常下鼻甲组织比较,P0.01,差异具有统计学意义;2.鼻息肉患者应用丙酸氟替卡松鼻喷剂前后对比,IL-5及GM-CSF的表达量和嗜酸性粒细胞浸润程度均明显减少,两两比较,P0.01差异具有统计学意义;3.鼻息肉组织中IL-5、GM-CSF的表达与嗜酸性粒细胞浸润程度呈正相关(应用丙酸辅替卡松鼻喷剂前后IL-5的表达与嗜酸性粒细胞浸润程度相关系数r=0.709、p0.01,r=0.877、p0.01;应用丙酸氟替卡松鼻喷剂前后GM-CSF的表达与嗜酸性粒细胞浸润程度相关系数r=0.723、p0.01,r=0.959、p0.01)。结论:1.鼻息肉组织中IL-5和GM-CSF蛋白均呈高表达,且其嗜酸性粒细胞浸润程度也增高,表明二者可增加嗜酸性粒细胞浸润,可能在鼻息肉的形成过程中起一定作用;2.鼻息肉患者在应用丙酸氟替卡松鼻喷剂后,鼻息肉组织中IL-5及GM-CSF的表达量均明显减少,表明丙酸辅替卡松鼻喷剂可以有效的控制鼻息肉组织中IL-5及GM-CSF的表达,从而减少嗜酸性粒细胞的浸润,抑制鼻息肉的发展;3.进一步解释了临床上鼻息肉术前应用丙酸氟替卡松鼻喷剂,可减轻炎症反应,防止术中出血,降低手术难度。
[Abstract]:Objective: to study the expression of IL-5 (interleukin-5) (IL-5) in patients with nasal polyps before and after treatment with fluticasone propionate nasal spray and in normal inferior turbinate tissues, and the expression of IL-5 (granulocyte-macrophage colony stimulating factor) was detected. To investigate the relationship between eosinophil infiltration and IL-5 GM-CSF expression in nasal polyps and the effect of nasal hormones on nasal polyps. To further reveal the mechanism of nasal glucocorticoid in the treatment of nasal polyps and its clinical significance. Methods: immunohistochemistry and computer image quantitative analysis were used to analyze the effect of glucocorticoid on nasal polyps. The expression of IL-5 and GM-CSF in nasal polyps and normal inferior turbinate was detected before and after fluticasone propionate nasal spray. Eosinophil infiltration in nasal polyps and normal inferior turbinate was detected by HE staining before and after fluticasone propionate nasal spray. The relationship between IL-5 GM-CSF (including before and after fluticasone propionate nasal spray) and the degree of eosinophil infiltration in each nasal polyp was plotted to analyze the correlation between IL-5 GM-CSF and eosinophilic granulocyte infiltration degree. Results: 1. Expression of IL-5 and GM-CSF in nasal polyps. The degree of eosinophilic granulocyte invasion increased, Compared with the normal inferior turbinate tissue, the difference was statistically significant. The expression of IL-5 and GM-CSF and the degree of eosinophil infiltration in nasal polyps were significantly decreased before and after the application of fluticasone propionate nasal spray. The expression of IL-5 and GM-CSF in nasal polyps was positively correlated with the degree of eosinophil infiltration (the expression of IL-5 and the degree of eosinophil infiltration before and after nasal spray with tikassone propionate) were positively correlated with the expression of IL-5 GM-CSF in nasal polyps. The correlation coefficient between the expression of GM-CSF and the degree of eosinophil infiltration before and after the application of fluticasone propionate nasal spray was 0. 709, p0. 01. Conclusion 1. The expression of IL-5 and GM-CSF protein were highly expressed in nasal polyps. The degree of eosinophil infiltration was also increased, indicating that both of them could increase eosinophil infiltration, which might play a role in the formation of nasal polyps. 2. After the application of fluticasone propionate nasal spray, the patients with nasal polyps may play a role in the formation of nasal polyps. The expression of IL-5 and GM-CSF in nasal polyps was significantly decreased, which indicated that the expression of IL-5 and GM-CSF in nasal polyps could be effectively controlled by propionic acid and tikassone nasal spray, thus reducing the infiltration of eosinophils. It is further explained that the application of fluticasone propionate nasal spray before operation of nasal polyps can reduce inflammation, prevent intraoperative bleeding and reduce the difficulty of operation.
【学位授予单位】：贵州医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R765.25
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本文编号：1624549