不同年份鼻息肉组织中炎性细胞分布的观察与比较

发布时间：2018-05-27 02:03

本文选题：鼻息肉 + 嗜酸性粒细胞　；参考：《青岛大学》2011年硕士论文

【摘要】：目的：观察近十年来不同年份鼻息肉组织中炎性细胞的分布情况,特别是嗜酸性粒细胞的数量变化,探讨不同时间段鼻息肉的组织学变化及可能的影响因素。方法：所有标本均来自于淄博市中心医院近十年来的住院病人并复习病历,选取1999年、2001年、2003年、2005年、2007年、2009年共6个年份的鼻息肉标本,每年份各20例,其中男10例,女10例,共120例,年龄在20-40岁之间。根据中华医学会1997年关于慢性鼻窦炎鼻息肉的分型分期标准均为Ⅱ型1-3期,所有患者均排除鼻腔鼻窦肿瘤、囊性纤维化、原发性纤毛运动障碍及真菌性鼻窦炎等相关性疾病、并排除明显解剖异常。术前1周未行抗生素、未行经鼻或口皮质类固醇激素等药物保守治疗。每份标本切片五张,HE染色,采用效果较好一张计数,每张HE染色切片选5个高倍镜视野(×400),手工计数嗜酸性粒细胞,中性粒细胞,淋巴细胞的数目,取其平均值,并进行统计学分析。同时,根据患者鼻息肉组织中嗜酸性粒细胞数目,分为嗜酸性粒细胞浸润组和非嗜酸性粒细胞浸润组,统计分析两组中嗜酸性粒细胞数,淋巴细胞数,中性粒细胞数。回顾性分析两组中患者的治愈好转率,治愈时间。结果：计算出不同年份鼻息肉组织中嗜酸性粒细胞、淋巴细胞、中性粒细胞数量的平均值进行两两比较,发现不同年份不同组别间的淋巴细胞与中性粒细胞的P值均大于0.05,差异无统计学意义。而嗜酸性粒细胞除99年份与01年份P0.05无统计学意义,其他均有显著差异,而且有逐渐上升趋势。两组间嗜酸性粒细胞数,淋巴细胞数,中性粒细胞数均有统计学意义。两两比较后发现,在嗜酸性粒细胞浸润型组织中,嗜酸性粒细胞最多,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最多,嗜酸性粒细胞次之,中性粒细胞多于嗜酸性粒细胞浸润型。嗜酸性粒细胞浸润型患者治愈好转率明显低于非嗜酸性粒细胞浸润型,治愈时间明显长于非嗜酸性粒细胞浸润型。嗜酸性粒细胞数与治愈时间呈正相关,与淋巴细胞呈负相关。结论：近十年来,鼻息肉组织中,嗜酸性粒细胞的数目呈现逐渐增加趋势,淋巴细胞,中性粒细胞数无明显变化。鼻息肉组织中嗜酸性粒细胞浸润越多患者治愈时间越长。根据组织细胞浸润特点结合临床表现对鼻息肉进行分类可能对了解鼻息肉发病机制、指导围手术期治疗有一定意义。
[Abstract]:Objective: to observe the distribution of inflammatory cells in nasal polyps in recent ten years, especially the changes of eosinophils, and to explore the histological changes and possible influencing factors of nasal polyps in different periods. Methods: all the specimens were collected from the inpatients in Zibo Central Hospital in the past ten years and their medical records were reviewed. The nasal polyps were collected from 1999, 2001, 2003, 2005, 2007 and 2009. There were 20 cases of nasal polyps each year, including 10 males and 10 females. A total of 120 cases, aged between 20 and 40 years old. According to the Chinese Medical Association's criteria for classification and staging of chronic sinusitis and nasal polyps in 1997, all patients were excluded from nasal cavity and sinusial tumors, cystic fibrosis, primary ciliary dyskinesia and fungal sinusitis. The obvious anatomic abnormality was excluded. No antibiotics were given 1 week before operation, and no conservative treatment was performed through nasal or oral corticosteroids. Five pieces of eosinophilic granulocyte, neutrophils and lymphocytes were counted in each section, and the average number of eosinophils, neutrophils and lymphocytes was calculated. Statistical analysis was carried out. At the same time, according to the number of eosinophil in nasal polyps, the patients were divided into eosinophil infiltration group and non-eosinophil infiltration group. The number of eosinophils, lymphocytes and neutrophils in the two groups were statistically analyzed. The cure rate and cure time of the patients in the two groups were analyzed retrospectively. Results: the average number of eosinophils, lymphocytes and neutrophils in nasal polyps in different years were calculated and compared in pairs. It was found that the P values of lymphocytes and neutrophils were higher than 0.05 in different groups in different years, and there was no significant difference between them. The eosinophils showed no significant difference except in 99 years and 01 years (P0.05), and the eosinophils showed a trend of increasing gradually. The number of eosinophilic granulocyte, lymphocyte and neutrophilic granulocyte were significantly different between the two groups. In the eosinophil infiltrating tissue, the eosinophil was the most, the lymphocyte was the second, and the neutrophil was the least. The number of lymphocytes in non-eosinophil infiltrating tissues was the most, followed by eosinophils, and neutrophil was more than eosinophil infiltration. The cure rate of patients with eosinophil infiltration type was significantly lower than that of non-eosinophil infiltration type, and the cure time was longer than that of non-eosinophil infiltration type. The number of eosinophilic granulocytes was positively correlated with the healing time and negatively correlated with lymphocytes. Conclusion: in the last ten years, the number of eosinophils in nasal polyps increased gradually, but the number of lymphocytes and neutrophils did not change significantly. The more eosinophil infiltration in nasal polyps, the longer the cure time. The classification of nasal polyps according to the characteristics of histocyte infiltration and clinical manifestations may be of significance in understanding the pathogenesis of nasal polyps and guiding the perioperative treatment.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R765.25

【相似文献】