非变应性鼻炎不同表型的炎症特征

发布时间：2018-04-18 11:15

本文选题：变应性鼻炎 + 非变应性鼻炎伴嗜酸性粒细胞增高征　；参考：《医学研究生学报》2017年03期

【摘要】：目的近年来国内外对变应性鼻炎(AR)主要特征变化进行了广泛研究,但对非变应性鼻炎(NAR)的研究却相对较少。文中旨在探讨NAR按照嗜酸性粒细胞(EOS)高低分型[非变应性鼻炎伴嗜酸细胞增多综合征(NARES)型、NAR不伴EOS增高型]分析不同表型NAR炎症特征。方法收集2016年1月至2016年7月初次在南京军区南京总医院耳鼻咽喉科就诊的NARES患者12例(NARES组)、NAR不伴嗜酸性粒细胞增高患者10例(NAR组)、AR患者12例(AR组)及体检健康者11例(对照组)。通过病史采集、皮肤点刺实验(SPT)、鼻灌洗细胞因子、血清细胞因子、外周血Treg细胞等方式评价分析各组炎症状况。结果 NARES组鼻灌洗IFN-γ含量[28.89(10.91~127.07)pg/m L]高于对照组[8.98(7.88~14.90)pg/m L]和NAR组[7.92(7.67~45.85)pg/m L],而鼻灌洗IL-10含量低于对照组[(3.97±0.68)pg/m L vs(4.80±1.32)pg/m L],差异有统计学意义(P0.05)。AR组和NARES组鼻灌洗IL-4、鼻灌洗IL-17、血清IL-17含量均高于对照组和NAR组(P0.05)。AR组和NARES组血清IL-4含量均高于对照组(P0.05)。外周血CD4+CD25+FOXP3+Treg细胞占CD4+T细胞比例,AR组[(4.5±1.3)%]、NARES组[(5.0±1.8)%]均明显低于对照组[(6.5±1.0)%]和NAR组[(6.6±2.0)%],差异有统计学意义(P0.05)。结论 NAR以EOS高低分型,NARES和NAR不伴EOS增高类型存在不同的炎症发生机制和炎症表现,而NARES和AR却出现了类似的Th2、Th17炎症表现,两者在炎症发生机制上具有一致性,将鼻炎按照是否存在EOS浸润分型更具有实际意义。
[Abstract]:Objective in recent years, the changes of the main characteristics of allergic rhinitis (ARR) have been extensively studied at home and abroad, but the studies of NAR) are relatively few.The aim of this study was to investigate the phenotypic NAR inflammatory characteristics of NAR according to the eosinophilic granulocyte (EOS) classification [non-allergic rhinitis accompanied with eosinophilic syndrome (NARES)].Methods from January 2016 to early July 2016, 12 patients with NARES in the Department of Otorhinolaryngology, Nanjing General Hospital of Nanjing military region, Nanjing military region were collected from 10 patients without eosinophilic granulocytosis.11 cases (control group).The inflammatory status of each group was evaluated by collecting history, skin prick test, nasal lavage cytokines, serum cytokines and peripheral blood Treg cells.Results the content of IFN- 纬 [28.89(10.91~127.07)pg/m L] in NARES group was higher than that in control group [8.98(7.88~14.90)pg/m L] and NAR group [7.92(7.67~45.85)pg/m L], but the content of IL-10 in nasal lavage group was lower than that in control group [3.97 卤0.68)pg/m L vs(4.80 卤1.32)pg/m L]. There was significant difference in IL-4 and IL-17 in NARES group and NARES group. The content of serum IL-17 was higher than that in NARES group.The levels of serum IL-4 in control group and NAR group were higher than those in control group and NARES group.The ratio of CD4 CD25 FOXP3 Treg cells to CD4 T cells in AR group was significantly lower than that in control group (6.5 卤1.0%) and NAR group (6.6 卤2.0%), and the difference was statistically significant (P 0.05).Conclusion there are different inflammatory mechanisms and manifestations between NAR and NAR without EOS elevation, while NARES and AR have similar Th _ 2T _ (17) inflammatory manifestations, which are consistent with each other in the pathogenesis of inflammation.It is of practical significance to classify rhinitis according to whether there is EOS infiltration.
【作者单位】：第二军医大学长海医院耳鼻咽喉科;南京军区南京总医院耳鼻咽喉科;
【基金】：呼吸疾病国家重点实验室开放课题(2007DA780154F0907) 南京军区南京总医院科研基金(2013010)
【分类号】：R765.21

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