鼻内镜术后不同疗效患者鼻粘膜T细胞亚群观察

OBSERVATION OF T CELL SUBGROUP IN NASAL MUCOSA OF DIFFERENT CURATIVE EFFECT IN CHRONIC SINUSITIS AFTER ENDOSCOPIC SINUS SURGERY

目的对比观察慢性鼻窦炎鼻内镜术后不同疗效惠者鼻粘膜免疫功能的差异。方法对48例慢性鼻窦炎患者行鼻内镜术6～12个月后的鼻粘膜进行CD4^＋和CD8^＋的免疫组织化学染色观察。结果术后不同疗效组之间CD4^＋、CD8^＋细胞数和CD4^＋／CD8^＋比值差异均有统计学意义（P〈0.01），CD4^＋／CD8^＋均倒置；疗效越好，CD4^＋／CD8^＋比值越高。结论慢性鼻窦炎患者鼻内镜术后6～12个月鼻粘膜中T细胞亚群分布仍不正常，但呈逐渐恢复趋势，鼻内镜术后鼻粘膜免疫防御功能的恢复可能是影响术后疗效的重要因素。

Objective To evaluate the immunological function of the nasal mucosa in the patients with different postoperative effects alter endoscope sinus surgery （ESS）. Methods 48 cases with chronic sinusitis were followed up for 6 to 12 months after endoscope sinus surgery. All the cases were divided into three groups： the cured group, the improved group and the ineffective group. Another ten normal cases were used as a normal control group. CD4^＋ and CD8^＋ cells of the nasal mucosa of different postoperative effects were counted by immunohistochemical method. Results There were significantly different in the numbers of CD4^＋ and CD8^＋ cells as well as in the ratio of CD4^＋ to CD8^＋ in the three postoperative groups, and the ratios of CD4^＋ to CD8^＋ of all groups were inverted except the normal control （P〈0. 01）. The better postoperative effect was, the higher the ratio of CD4^＋ to CD8^＋ was. Conclusion The results indicate that the distribution of T- lymphocyte subsets in postoperative nasal mucosa is still abnormal from 6 to 12 months. The recovery of immunological function of nasal mucosa may be an important factor of postoperative effects.