呼吸道病毒与慢性鼻—鼻窦炎的相关性研究

发布时间：2018-07-12 21:53

本文选题：慢性鼻鼻窦炎 + 中鼻道外侧壁粘膜上皮细胞　；参考：《华中科技大学》2012年硕士论文

【摘要】：【目的】通过对慢性鼻-鼻窦炎粘膜上皮细胞中呼吸道病毒的定性检测，观察呼吸道病毒在慢性鼻鼻窦炎持续期中是否存在及存在种类的差别，以期发现病毒在此疾病中的作用。【材料和方法】 Control组病例共计27例，男性19例，女性8例，平均年龄32.1岁，病程从6天～十余年；CRSsNP组病例共计30例，男性22例，女性8例，平均年龄58.7岁，病程三月余～20余年；CRSwNP组病例共计35例，男性25例，女性10例，平均年龄37.4岁，病程半年余～20余年；其中伴血嗜酸性粒细胞增高（Eo增高）10例，不伴嗜酸性粒细胞增高（Eo正常）25例。对符合入组条件病例，在鼻内镜下用鼻粘膜刮匙刮取中鼻道外侧壁粘膜上皮细胞，上皮细胞提取RNA后用聚合酶链反应（PCR）技术行常见呼吸道病毒检测。【结果】在92名患者中，检测到总病毒阳性率为71.7%，但三组之间无差异，分别为77.8%、70%、68.6%。各种病毒构成比中RV的总体阳性率最高，为33%，其次是Inf-A（20%），然后依次为Inf-B和PIV-1（均为15%）、RSV（13%）、OC43(12%)、PIV3（10%），PIV-2和229E阳性率较低，为3%。但是在三组患者之间每种病毒阳性率未发现统计学差异结论，除了PIV-2和229E只存在于Control组。PIV-1在Eo增高组（40%）和Eo正常组（4%）有显著统计学差异。男性患者在各组之间的阳性率均比女性为高。【结论】 1、检测的总的病毒阳性率为71.7%，在各种阳性病毒中，RV的总体阳性率最高，但在三组之间无明显统计学差异，提示在正常情况下鼻腔粘膜即定植大量病毒，其中鼻病毒是最常见类型，但慢性鼻-鼻窦炎并不比正常人对呼吸道病毒更易感，病毒也不在慢性鼻-鼻窦炎持续期的病理机理中起重要作用。 2、病毒多重阳性率在总的阳性结果中占相当大的比例（41/66），超过一半为多重病毒感染，但在三组之间并无差别，提示我们多种病毒同时存在于鼻腔内应该属于自然常态，单独的病毒共存状态并不增加其致病性。 3、各组男性病人检测的病毒阳性率均比女性为高，提示呼吸道病毒可能更易定植于男性，男、女的易感病毒种类也有所差异，但并不造成更多的显性感染。
[Abstract]:[objective] to investigate the existence and type of respiratory viruses in chronic rhinosinusitis by qualitative detection of respiratory viruses in mucosal epithelial cells of chronic rhinosinusitis. [materials and methods] there were 27 cases in the Control group, 19 males and 8 females, with an average age of 32.1 years. The course of disease ranged from 6 days to more than 10 years in 30 cases of CRSsNP group. There were 22 males and 8 females with an average age of 58.7 years. There were 35 cases in CRSwNP group in more than 20 years after three months. There were 25 males and 10 females with an average age of 37.4 years. The course of disease was more than half a year. There were 10 cases with eosinophil elevation (Eo) and 25 cases without eosinophil elevation (Eo normal). The epithelial cells of the lateral wall of the middle nasal canal were curetted with nasal mucosal curette under nasal endoscope for the patients who fit the condition of entry. RNA was extracted from epithelial cells and detected by polymerase chain reaction (PCR). [results] in 92 patients, the positive rate of total virus was 71.7, but there was no difference among the three groups, which were 77.8% and 68.6%, respectively. The overall positive rate of RV was 33, followed by Inf-A (20%), followed by Inf-B and PIV-1 (15%), RSV (13%), OC43 (12%), PIV3 (10%), PIV-2 and 229E (329E). However, there was no significant difference in the positive rate of each virus among the three groups, except that PIV-2 and 229E only existed in Control group. PIV-1 was significantly different in Eo elevated group (40%) and Eo normal group (4%). The positive rate of male patients was higher than that of females. [conclusion] 1. The total positive rate of virus detected was 71.7 and the positive rate of RV was the highest among all kinds of positive viruses. But there was no significant statistical difference among the three groups, suggesting that a large number of viruses were colonized in the nasal mucosa under normal conditions, of which rhinovirus was the most common type, but chronic rhinosinusitis was not more susceptible to respiratory viruses than normal people. The virus also does not play an important role in the pathological mechanism of chronic rhinosinusitis. 2. The multiple positive rate of the virus accounts for a large proportion of the total positive results (41 / 66), and more than half are multiplex virus infections. But there is no difference among the three groups, suggesting that multiple viruses should exist in the nasal cavity at the same time as the natural normal. The coexistence of viruses alone did not increase their pathogenicity. 3. The positive rate of viruses detected by male patients in each group was higher than that of women, suggesting that respiratory viruses may be more susceptible to infection in men, men and women, and there are also differences in the types of susceptible viruses. But it does not cause more dominant infections.
【学位授予单位】：华中科技大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R765.41

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