DJ-1蛋白对慢性鼻窦炎和鼻息肉发病和预后及与中医证型的相关研究

发布时间：2018-08-10 21:22

【摘要】：目的:采取免疫组化的方法,通过观察DJ-1蛋白在慢性鼻窦炎及鼻息肉中的表达情况来研究DJ-1蛋白与慢性鼻窦炎和鼻息肉发病与预后以及与中医证型相关性。材料和方法:本课题采用免疫组化实验的方法,于临床上筛选70例慢性鼻窦炎、53例鼻息肉及28例难治性慢性鼻-鼻窦炎病变组织与20例正常鼻黏膜组织石蜡标本,分别检测其中DJ-1蛋白的表达情况。根据患者病史、症状、体征,结合中医望、闻、问、切四诊,对患者进行辨证分型,运用X2检验统计分析DJ-1蛋白与慢性鼻窦炎和鼻息肉发病与预后以及与中医证型相关性。结果:(1)DJ-1蛋白表达于鼻黏膜上皮、腺上皮、杯状细胞的细胞胞浆和胞核中;(2)慢性鼻窦炎、鼻息肉及难治性慢性鼻-鼻窦炎和正常鼻黏膜组织之间DJ-1蛋白阳性强度是有显著性差异的(X2=148.002,P㩳0.001)。其中慢性鼻窦炎的阳性强度以“+++”为主,鼻息肉的阳性强度以“+”为主,难治性慢性鼻-鼻窦炎组织的阳性强度以“-~+”为主,而正常鼻黏膜组织阳性强度以“++”为主;(3)慢性鼻窦炎胆腑郁热型、脾胃湿热型、肺气虚寒型和脾气虚弱型DJ-1蛋白阳性强度构成比无明显差异(X2=4.407,P=0.6220.05);鼻息肉寒湿凝聚与湿热蕴结型DJ-1蛋白阳性强度构成比亦无明显差异(X2=0.008,P=0.9350.05)。结论:本次免疫组化研究发现DJ-1蛋白在慢性鼻窦炎组织中表达最高,而在鼻息肉中表达较低,从这一点也可以认为慢性鼻窦炎与鼻息肉是两个相对独立的疾病或者是同一疾病的不同发展阶段。DJ-1蛋白的表达差异对慢性鼻窦炎及鼻息肉的发病及预后有着重要的作用。DJ-1蛋白在慢性鼻窦炎和鼻息肉各证型中的表达情况无显著性差异,原因可能是中医的辨证分型带有一定主观性或者患者证型可随外邪内因发生改变;另一方面,可能因为样本量较小,若将来扩大样本量研究,也许会获得不同的结果。
[Abstract]:Objective: to observe the expression of DJ-1 protein in chronic sinusitis and nasal polyps by immunohistochemical method to study the relationship between DJ-1 protein and chronic sinusitis and nasal polyps and the prognosis of chronic sinusitis and nasal polyps. Materials and methods: in this study, 70 cases of chronic sinusitis and 53 cases of nasal polyps, 28 cases of refractory chronic rhinosinusitis and 20 cases of normal nasal mucosa were selected by immunohistochemical method. The expression of DJ-1 protein was detected. According to the history, symptoms and signs of the patients, combined with traditional Chinese medicine, smell, ask, cut four diagnosis, the patients were differentiated and classified, using X2 test statistical analysis of the DJ-1 protein and chronic sinusitis and nasal polyps, and the relationship between the pathogenesis and prognosis and TCM syndromes. Results: (1) DJ-1 protein was expressed in cytoplasm and nucleus of nasal mucosa epithelium, glandular epithelium, goblet cells, (2) chronic sinusitis, The positive intensity of DJ-1 protein was significantly different between nasal polyps and refractory chronic rhinosinusitis and normal nasal mucosa. The positive intensity of chronic sinusitis was mainly ", the positive intensity of nasal polyps was", and the positive intensity of refractory chronic rhinosinusitis was "-~". The positive intensity of normal nasal mucosa was mainly ". (3) chronic sinusitis, damp-heat type of spleen and stomach, There was no significant difference in the positive intensity ratio of DJ-1 protein between the lung qi deficiency cold type and the weak temper type (X2P 4.407), and there was no significant difference in the ratio of DJ-1 positive intensity between the cold and wet condensation type and the damp-heat accumulation type of nasal polyp (X2 0. 008 PJ 0. 935 05). Conclusion: the expression of DJ-1 protein was the highest in chronic sinusitis and low in nasal polyps. From this point, it can be concluded that chronic sinusitis and nasal polyps are two relatively independent diseases or different stages of development of the same disease. DJ-1 protein expression differences are important for the pathogenesis and prognosis of chronic sinusitis and nasal polyps. There was no significant difference in the expression of DJ-1 protein in chronic sinusitis and nasal polyps. The reason may be that the syndrome differentiation of TCM is subjective or the type of patient's syndrome can change with the internal cause of external pathogens; on the other hand, it may be because of the small sample size, if the study of sample size is expanded in the future, different results may be obtained.
【学位授予单位】：云南中医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R276.1

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