糖皮质激素治疗鼻息肉的临床分析

发布时间：2018-02-22 16:44

本文关键词： 糖皮质激素鼻息肉黏膜糖皮质激素受体机制　出处：《大连医科大学》2010年硕士论文　论文类型：学位论文

【摘要】： 目的： 1.对鼻息肉患者鼻息肉组织及正常鼻腔粘膜组织中糖皮质激素受体进行检测分析,并对比两者糖皮质激素受体分布情况,探寻其表达分布的规律性。 2.进一步探讨糖皮质激素在鼻息肉围手术期处理中应用的合理性及糖皮质激素治疗鼻息肉的相关机制。材料与方法收集2009年1月-12月期间大连医科大学附属第二医院耳鼻咽喉科门诊及住院患者60例,其中30例为已确诊为鼻息肉的手术患者(经临床检查、取病理送检和鼻窦CT扫描后确诊为鼻息肉),取其息肉组织作为研究对象。另取30例正常人一侧下鼻甲前端黏膜作为正常对照组。通过HE染色及免疫组化SP法,检测鼻息肉和正常下鼻甲黏膜中糖皮质激素受体的表达和分布情况。最后对实验数据进行统计学分析。结果：糖皮质激素受体在鼻息肉组及正常对照组中均有阳性表达,主要表现为胞浆、胞核中出现浅黄色至棕褐色阳染颗粒。鼻息肉组中阳性细胞主要集中表达于鼻息肉表面的上皮细胞层、基底细胞及囊性扩张的腺体细胞,间质内的血管内皮细胞及嗜酸性粒细胞等炎性细胞也有阳性表达。正常对照组主要表达于下鼻甲黏膜上皮层及基底细胞层。对鼻息肉组和正常对照组中糖皮质激素受体阳性细胞表达数据进行统计学分析。经t检验显示鼻息肉组与正常对照组存在差异性(P0.05),有统计学意义。结论： 1.糖皮质激素治疗是鼻息肉围手术期处理的重要组成部分。通过检测鼻息肉组织中糖皮质激素受体的表达情况,可以指导临床合理使用糖皮质激素。 2.鼻息肉组织中糖皮质激素受体的表达水平可能是影响糖皮质激素治疗效果的关键性因素,即糖皮质激素受体的数量,可能决定着糖皮质激素的治疗效应。 3.通过对糖皮质激素活化鼻息肉组织中糖皮质激素受体作用的进一步研究有助于揭示糖皮质激素治疗鼻息肉的详细机制。
[Abstract]:Objective:. 1. The glucocorticoid receptors in nasal polyps and normal nasal mucosa were detected and analyzed, and the distribution of glucocorticoid receptors in nasal polyps and normal nasal mucosa were compared to find out the regularity of the expression and distribution of glucocorticoid receptors. 2. To further explore the rationality of glucocorticoid in the perioperative treatment of nasal polyps and the related mechanism of glucocorticoid in the treatment of nasal polyps. Materials and methods. From January 2009 to December, 60 outpatients and inpatients of the Department of Otorhinolaryngology, second affiliated Hospital of Dalian Medical University were collected. Among them, 30 cases were diagnosed as surgical patients with nasal polyps. The nasal polyp was diagnosed by pathological examination and CT scan of paranasal sinuses, and the tissue of nasal polyp was taken as the study object. The mucosa of the anterior part of inferior turbinate of 30 normal people was taken as the normal control group. The mucosa was stained by HE and SP immunohistochemical method. The expression and distribution of glucocorticoid receptors in nasal polyps and normal inferior turbinate mucosa were detected. Results:. The expression of glucocorticoid receptor was positive in nasal polyp group and normal control group. In the nasal polyp group, the positive cells were mainly expressed in the epithelial cell layer, basal cells and cystic dilated gland cells on the surface of nasal polyps. The vascular endothelial cells and eosinophilic granulocytes in the interstitial tissue were also positive. The normal control group was mainly expressed in the epithelial layer and basal cell layer of the inferior turbinate mucous membrane. In the nasal polyp group and the normal control group, the glucocorticoid was stimulated. The difference between nasal polyp group and normal control group was significant (P 0.05). Conclusion:. 1. Glucocorticoid therapy is an important part of perioperative management of nasal polyps, and the expression of glucocorticoid receptors in nasal polyps can be detected to guide the rational use of glucocorticoids in clinical practice. 2. The expression level of glucocorticoid receptor in nasal polyps may be the key factor affecting the effect of glucocorticoid therapy, that is, the quantity of glucocorticoid receptor may determine the therapeutic effect of glucocorticoid. 3. Further study on glucocorticoid receptor activation in nasal polyps is helpful to reveal the mechanism of glucocorticoid in the treatment of nasal polyps.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R765

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