幽门螺杆菌及真菌与鼻息肉相关性的研究

发布时间：2018-06-27 01:36

本文选题：幽门螺杆菌 + 真菌　；参考：《南昌大学》2011年硕士论文

【摘要】：目的：鼻息肉是鼻腔和鼻窦粘膜的常见慢性疾病,其发病率高、复发倾向性强。目前关于鼻息肉的发病机理亦不是很明确。可能与感染因素、过敏和免疫功能紊乱有关。但已有研究表明,炎症是鼻息肉发生的一个重要的因素,所以感染是始终在鼻息肉的发病中占有重要地位。详细的病因学研究对病人的评估和疾病的治疗很重要。幽门螺杆菌是最常见的慢性感染病原体,是一种革兰氏阴性微需氧螺旋杆菌,环境氧要求5～8%。它通常寄生在人的胃粘膜粘液层。虽然胃组织是幽门螺杆菌的天然水库,但国外已经在胃以外组织如牙斑、口腔、唾液、扁桃体、腺样体及鼻腔鼻窦中发现了幽门螺杆菌,并认为幽门螺杆菌可能对慢性鼻窦炎鼻息肉有关系。真菌是广泛存在于自然界中的一种病原微生物,其致病力一般比较弱,它是鼻腔中的正常菌群,可存在于健康人的呼吸道中而不发病,但是有些真菌在一定条件下可以致病。近年来,关于真菌是慢性鼻窦炎的致病因素之一越来越受到重视,其在鼻息肉的发生中的作用也正在受到越来越多的关注,真菌病在国际上的研究日益深入,国内也有相关的报道真菌与鼻息肉的发病可能有一定的关系。本试验通过对鼻息肉中幽门螺杆菌及真菌检测来探讨幽门螺杆菌及真菌与鼻息肉之间是否存在着一定的关系。方法：取我院2010年3月至2010年12月间35名患有鼻息肉患者作为实验组；30例鼻中隔偏曲或鼻中隔骨折患者经鼻内镜及鼻窦CT检查没有鼻息肉患者作为对照组。术前对两组病人进行真菌的皮肤点刺试验及吸入变应原特异性免疫球蛋白IgE(SIgE)测定,实验组取中鼻道息肉作为标本,对照组取从中鼻甲外侧壁鼻粘膜作为标本,将两组标本均进行快速尿素酶试及免疫组织化学检测其幽门螺杆菌,并对数据进行相关性分析。应用SPSS17.0的统计软件进行统计学处理。结果： 1、快速尿素酶试验阳性率的对照,采用卡方检验(pearson chi-square)结果为：试验组中,有3例(8.6%)阳性病例,32例(91.4%)阴性病例；对照组中,有2例(6.7%)阳性病例,28例(93.3%)阴性病例。卡方检验P=0.774,无显著统计学差异。 2、免疫组织化学试验阳性率的对照：试验组和对照组未见阳性病例,无统计学意义。 3、皮肤点刺试验阳性率的对照,采用卡方检验(pearson chi-square)结果为：试验组中,有6例(17.1%)阳性病例,32例(82.9%)阴性病例；对照组中,有2例(6.7%)阳性病例,28例(93.3%)阴性病例。卡方检验P=0.27,无显著统计学差异,但实验组中真菌表达的阳性率有增高的趋势。 4、吸入变应原特异性免疫球蛋白IgE(SIgE)测定阳性率的对照,采用卡方检验(pearson chi-square)结果为：试验组中,有8例(22.9%)阳性病例,27例(77.1%)阴性病例；对照组中,有3例(10.0%)阳性病例,27例(90.0%)阴性病例。卡方检验P=0.168,无显著统计学差异,但实验组中真菌表达的阳性率有增高的趋势。结论：通过对实验组及对照组快速尿素酶试验及免疫组织化学检测的统计学分析,幽门螺杆菌与鼻息肉无统计学意义,故我们认为幽门螺杆菌与鼻息肉无直接相关性。通过对实验组及对照组皮肤点刺试验和吸入变应原特异性免疫球蛋白IgE(SIgE)测定发现在鼻息肉患者中能够检测到有真菌的存在,虽不能证明真菌在鼻息肉的发生中有直接关系,但真菌在鼻息肉的发病机制中可能发挥一定的作用。
[Abstract]:Objective: nasal polyps are common chronic diseases of nasal cavity and sinus mucosa. The incidence of nasal polyps is high and relapse is strong. The pathogenesis of nasal polyps is not very clear at present. It may be related to infection factors, allergies and immune dysfunction. However, it has been shown that inflammation is an important factor in the occurrence of nasal meat, so infection is the beginning. It is important in the pathogenesis of nasal polyps. Detailed etiological study is important for the evaluation of the patients and the treatment of the disease. Helicobacter pylori is the most common chronic infection pathogen. It is a gram-negative micro aerobibacillus. The environmental oxygen requirement is 5 ~ 8%.. It usually parasitism in the mucous mucous layer of the human stomach. Although the gastric tissue is A natural reservoir of Helicobacter pylori, however, Helicobacter pylori has been found in outside gastric tissues such as dental plaque, mouth, saliva, tonsil, adenoids, and nasal sinuses, and that Helicobacter pylori may be associated with chronic rhinosinusitis and nasal polyps. Fungi are a pathogenic microorganism widely found in nature, and its pathogenicity is generally compared. It is weak, it is the normal flora of the nasal cavity, which can exist in the respiratory tract of healthy people, but some fungi can be pathogenetic under certain conditions. In recent years, the fungus is one of the pathogenic factors of chronic sinusitis. The role of fungi in the occurrence of nasal polyps is also being paid more and more attention. The study of diseases in the world is becoming more and more in-depth. There are also related reports that fungi may have a certain relationship with the onset of nasal polyps. This test is to explore the relationship between Helicobacter pylori and fungi and nasal polyps by detecting Helicobacter pylori and fungi in nasal polyps.
Methods: 35 patients with nasal polyps were taken as experimental group from March 2010 to December 2010. 30 cases of nasal septum deviation or nasal septum fracture were examined by nasal endoscopy and CT examination without nasal polyps as control group. Before operation, the skin prick test and inhaled allergens specific immunoglobulin Ig were carried out in two groups of patients. E (SIgE) test, the experimental group took middle nasal polyp as a specimen, the control group was taken from the nasal mucosa of the lateral wall of the middle turbinate as a specimen. The two groups were tested by rapid urease test and immunohistochemistry, and the data were analyzed by correlation analysis. The statistical software of SPSS17.0 was used to carry out statistical processing.
Result:
1, the positive rate of the rapid urease test was compared with the results of chi square test (Pearson chi-square). In the experimental group, there were 3 (8.6%) positive cases and 32 (91.4%) negative cases; in the control group, there were 2 (6.7%) positive cases and 28 (93.3%) negative cases. The chi square test P=0.774 had no significant statistical difference.
2, the positive control rate of immunohistochemical test: the experimental group and the control group did not see positive cases, there was no statistical significance.
3, the positive rate of the skin prick test was compared with the chi square test (Pearson chi-square). In the experimental group, there were 6 (17.1%) positive cases and 32 (82.9%) negative cases; in the control group, there were 2 (6.7%) positive cases and 28 (93.3%) negative cases. The chi square test P=0.27 had no significant statistical difference, but the positive expression of fungi in the experimental group was positive. There is a tendency to increase the sex rate.
4, the positive rate of inhaled allergens specific immunoglobulin IgE (SIgE) was measured by chi square test (Pearson chi-square). In the experimental group, there were 8 (22.9%) positive cases, 27 (77.1%) negative cases, 3 (10%) positive cases and 27 (90%) negative cases in the control group. The chi square test P=0.168 had no significant statistical difference. The positive rate of fungal expression in the experimental group has a tendency to increase. Conclusion: there is no statistical significance between Helicobacter pylori and nasal polyps through the statistical analysis of the rapid urease test and immunohistochemical detection of the experimental group and the control group. Therefore, we think that Helicobacter pylori has no direct correlation with the nasal polyps. Skin prick test and inhaled allergen specific immunoglobulin IgE (SIgE) test found that the presence of fungi in nasal polyps can be detected, although it can not prove that fungi have a direct relationship in the occurrence of nasal polyps, but fungi can play a role in the pathogenesis of nasal polyps.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R765.25

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