不同时期鼻息肉组织中炎性细胞及趋化因子eotaxin和RANTES的观察与比较

发布时间：2018-05-17 17:04

本文选题：鼻息肉 + 嗜酸性粒细胞　；参考：《青岛大学》2012年硕士论文

【摘要】：第一部分不同时期鼻息肉组织中炎性细胞的观察和比较目的观察近八年中不同年份鼻息肉组织中炎性细胞的分布情况,尤其是嗜酸性粒细胞的浸润情况与数量变化,探讨不同时期鼻息肉的组织病理学变化,可能的影响因素及其与治愈时间的关系。方法所有鼻息肉标本均来自青岛大学医学院耳鼻喉科的住院患者,并对这些患者的临床资料进行回顾性分析。选取2004年1月—2011年12月共8个年份的鼻息肉标本,每年20例,共160例,其中男122例,女38例,年龄19—79岁。按照中华医学会关于变应性鼻炎的诊断标准,对患者进行临床类型的分型。所有患者均排除支气管哮喘、鼻部良恶性肿瘤、囊性纤维化、不动纤毛综合征、真菌性鼻窦炎等相关性疾病,并排除明显解剖异常,且所有患者术前一周未行抗生素、未经口或鼻给予皮质类固醇激素等药物治疗。对160例鼻息肉标本进行HE染色,光学显微镜下每张切片选取5个高倍视野(×400),手工计数嗜酸性粒细胞、淋巴细胞、中性粒细胞个数,并根据鼻息肉组织中嗜酸性粒细胞的个数进行组织学类型划分,将标本分为嗜酸性粒细胞浸润型和非嗜酸性粒细胞浸润型。计算出不同年份、不同临床类型、不同组织学类型鼻息肉标本中三种炎性细胞的平均值,并进行方差分析、两两比较及t检验；同时对160例鼻息肉患者的治愈时间、嗜酸性粒细胞数、淋巴细胞数及中性粒细胞数进行相关性分析。结果不同年份鼻息肉组织中,平均嗜酸性粒细胞数的差异无统计学意义(F=1.961,P0.05),数目呈现波状变化趋势,以2009年数目最多,2011年和2007年次之；淋巴细胞和中性粒细胞平均值亦无统计学差异(P0.05)。不同临床类型、不同组织学类型间平均嗜酸性粒细胞数存在统计学差异(P0.01),而平均淋巴细胞数、中性粒细胞数无统计学差异(P0.05)。不同组织学类型中,嗜酸性粒细胞浸润型鼻息肉中,嗜酸性粒细胞数最多,淋巴细胞次之,中性粒细胞最少；在非嗜酸性粒细胞浸润型组织中,淋巴细胞数最多,随后是嗜酸性粒细胞和中性粒细胞。嗜酸性粒细胞浸润型患者治愈时间明显长于非嗜酸性粒细胞浸润型患者(t=17.552,P0.01),嗜酸性粒细胞数与治愈时间呈正相关(r=0.255,P0.01),其与淋巴细胞数呈负相关(r=—0.199,P0.05),中性粒细胞数与嗜酸性粒细胞、淋巴细胞的相关性无统计学意义(P0.05)。结论鼻息肉组织中,嗜酸性粒细胞数在近八年中未呈现明显增加或减少的变化趋势,其中2009年数目最多,2011年和2007年次之；淋巴细胞和中性粒细胞数目亦无明显变化。不同临床类型、不同组织学类型的患者,其鼻息肉组织中浸润的炎性细胞有所不同。嗜酸性粒细胞浸润型患者治愈时间明显长于非嗜酸性粒细胞浸润型患者,且嗜酸性粒细胞浸润越多,患者治愈时间越长。根据组织中炎性细胞浸润的特点对鼻息肉进行分类,可能对了解疾病发病机制,指导治疗及预后有一定意义。第二部分不同时期鼻息肉组织中趋化因子eotaxin和RANTES的表达和意义目的观察近八年中不同年份鼻息肉组织中趋化因子eotaxin和RANTES的表达情况,探讨其在不同时期鼻息肉组织中的表达意义和变化趋势,及其与嗜酸性粒细胞的相关性。方法所有鼻息肉标本均来自青岛大学医学院耳鼻喉科的住院患者,选取2004年1月—2011年12月共8个年份的鼻息肉标本,每年5例,共40例,其中男28例,女12例,年龄21—78岁。对40例鼻息肉标本进行HE染色和免疫组织化学染色,光学显微镜下计数嗜酸性粒细胞数目并检测趋化因子eotaxin和RANTES的平均光密度值(AOD)。根据嗜酸性粒细胞个数,对鼻息肉进行组织学类型划分。计算出不同年份鼻息肉标本中嗜酸性粒细胞的平均值,以及eotaxin和RANTES的光密度值,进行方差分析、两两比较、t检验及相关性分析。结果不同年份鼻息肉组织中嗜酸性粒细胞数、eotaxin和RANTES的光密度值均有统计学差异(P0.05),并呈现逐年增加趋势,两两比较发现,04年与09、10、11年平均值存在统计学差异(P0.05),其余年份两两比较后差异无统计学意义(P0.05)。不同组织学类型间,嗜酸性粒细胞数、eotaxin和RANTES的光密度值亦存在统计学差异(P0.001),且嗜酸性粒细胞数与eotaxin、RANTES表达量呈正相关(P0.05)。结论在近八年的鼻息肉组织中,嗜酸性粒细胞数目、eotaxin表达量、RANTES表达量均呈现逐年上升的动态趋势,且不同组织学类型的患者,其趋化因子的表达量存在差异,嗜酸性粒细胞浸润型患者的eotaxin、RANTES表达量明显多于非嗜酸性粒细胞浸润型患者,且二者表达量越多,嗜酸性粒细胞浸润越多。该研究对了解鼻息肉中嗜酸性粒细胞浸润机制及指导临床治疗有一定意义。
[Abstract]:The first part is the observation and comparison of inflammatory cells in nasal polyps at different stages.
Objective To observe the distribution of inflammatory cells in nasal polyps in different years, especially the infiltration and quantity of eosinophils, and to explore the histopathological changes of nasal polyps in different periods, the possible influencing factors and the relationship with the cure time.
Methods all the nasal polyps were from the hospitalized patients in the Department of ENT of the Medical College of Qiingdao University, and the clinical data of these patients were analyzed retrospectively. The specimens of nasal polyps in 8 years from January 2004 to December 2011 were selected, 20 cases each year, including 160 cases, including 122 male, 38 female, 19 to 79 years old. All patients excluded bronchial asthma, benign and malignant tumors of the nose, cystic fibrosis, ciliated syndrome, fungal sinusitis and other related diseases, and excluded obvious anatomic abnormalities, and all patients were not given antibiotics one week before operation, without oral or nasal administration. Steroid hormones such as drug treatment.
160 cases of nasal polyps were stained with HE, and 5 high times of visual field (x 400) were selected for each slice under optical microscope. The number of eosinophils, lymphocytes and neutrophils were counted by hand, and the histological types were divided according to the number of eosinophils in the nasal polyps. The specimens were divided into eosinophil infiltrating and non eosinophils. The average value of three kinds of inflammatory cells in different years, different clinical types and different histological types of nasal polyps were calculated, and the variance analysis, 22 comparison and t test were carried out. At the same time, the cure time, the number of eosinophils, the number of lymphocyte and the number of neutrophils in 160 cases of nasal polyps were related. Sex analysis.
Results the average number of eosinophils in the nasal polyps in different years was not statistically significant (F=1.961, P0.05), and the number showed a wave change trend, which was the largest in 2009, in 2011 and 2007. The mean value of lymphocyte and neutrophils was not statistically different (P0.05). Different clinical types and different histological types were found. There was a significant difference in mean eosinophil count (P0.01), but there was no significant difference in mean lymphocyte count and neutrophil count (P0.05).
Among the different histological types, eosinophil infiltrated nasal polyps were the most eosinophil and the least neutrophils. In the non eosinophilic granulocyte infiltrating tissue, the number of lymphocytes was the most, followed by eosinophils and neutrophil cells. The cure time of eosinophil infiltrating patients was obvious. There was a positive correlation between the number of eosinophils and the cure time (r=0.255, P0.01). The number of eosinophils was negatively correlated with the number of lymphocytes (r= 0.199, P0.05), the number of neutrophils and eosinophils, and there was no statistically significant correlation between the number of neutrophils and lymphocytes (P0.05), which was longer than t=17.552 (P0.01).
Conclusion the number of eosinophils in nasal polyps has not been significantly increased or decreased in the last eight years. The number of eosinophils in 2009 is the most, in 2011 and 2007. There is no obvious change in the number of lymphocytes and neutrophils. Patients with different clinical types, different histological types, and infiltrating inflammation in their nasal polyps The cure time of eosinophil infiltrating type patients is significantly longer than that of non eosinophil infiltrating patients, and the more eosinophil infiltration, the longer the patient is cured. The classification of nasal polyps according to the characteristics of inflammatory cell infiltration in the tissue may be to understand the pathogenesis, guide treatment and prognosis of the disease. It is of certain significance.
The second part
Expression and significance of chemokine eotaxin and RANTES in nasal polyps at different stages
Objective To observe the expression of chemokine eotaxin and RANTES in nasal polyps in different years in different years, and to explore the significance and trend of its expression in nasal polyps at different stages and the correlation with eosinophils.
Methods all the nasal polyps were from the hospitalized patients in the Department of ENT of the Medical College of Qiingdao University and selected the nasal polyps in 8 years from January 2004 to December 2011. There were 5 cases each year. There were 40 cases, including 28 male, 12 female, 21 to 78 years old. 40 cases of nasal polyps were stained with HE and immunohistochemical staining, and counted under optical microscope. The number of eosinophils and the average optical density value (AOD) of chemokine eotaxin and RANTES were measured. According to the number of eosinophils, the histological types of nasal polyps were divided. The average value of eosinophils in nasal polyps in different years, and the light density values of eotaxin and RANTES were calculated, and the variance analysis was carried out, 22 comparison, T test and correlation analysis.
Results the number of eosinophils, eotaxin and RANTES in different years of nasal polyps were statistically different (P0.05), and showed an increasing trend year by year. 22 compared with the average value of 04 years and 09,10,11 years, there was statistical difference (P0.05), and the difference between the other years 22 after the comparison was not statistically significant (P0.05). There were also statistical differences (P0.001) between the number of eosinophils, eotaxin and RANTES, and the number of eosinophils was positively correlated with the expression of eotaxin and RANTES (P0.05).
Conclusion in the recent eight years, the number of eosinophils, the expression of eotaxin and the expression of RANTES in the nasal polyps were increasing year by year, and the expression of chemokine in the patients with different histology types was different. The expression of eotaxin in eosinophil infiltrating patients was more than that of non eosinophilic granules. The more expression of the two patients, the more eosinophil infiltration is more. This study is of certain significance to understand the mechanism of eosinophil infiltration in nasal polyps and to guide clinical treatment.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R765.25

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