家兔急性鼻窦炎鼻源性模型的建立

The establishment of a rhinogenic model of acute sinusitis in rabbits

目的探讨在家兔鼻腔填塞膨胀海绵并植入细菌以制备急性鼻窦炎鼻源性动物模型的方法。方法健康成年雄性新西兰白兔30只,随机抽取5只处死,测量其右侧鼻腔前鼻孔上下径、内外径以及前鼻孔至上颌窦自然开口的距离,余25只分成模型组(10只)、单纯堵塞组(10只)和空白对照组(5只)。将2.5 mm×5 mm×28 mm大小Merocel高分子膨胀海绵置入模型组、单纯堵塞组兔右侧鼻腔,同时向模型组兔鼻腔内高分子膨胀海绵中注射植入1 mlⅢ型肺炎链球菌悬液,单纯堵塞组注射等量生理盐水。第10天行鼻窦CT扫描后将兔处死,分别取右上颌窦、筛窦窦腔分泌物行细菌培养,并将右上颌窦、筛窦完整取出,全组织包埋行组织病理学检查。结果除模型组1只于第4天死亡外,其余均存活。模型组家兔CT检查均示右上颌窦、筛窦腔不同程度浑浊化,鼻窦腔内分泌物细菌培养阳性率为100%,光镜观察可见窦腔大量中性粒细胞聚积,上皮变性,局部溃疡形成,黏膜内及黏膜下大量炎性细胞浸润。单纯堵塞组8只家兔可见类似的影像学改变,但病理学改变程度较轻,与模型组相比,差别有统计学意义。结论成功建立了家兔急性鼻窦炎的鼻源性动物模型,为进一步研究鼻源性鼻窦炎的发病机制及治疗干预奠定基础。

Objective To create a rhinogenic model of acute sinusitis using an implanted sponge impregnated with pathogenic bacteria in the nasal cavity of the rabbits. Methods Thirty healthy adult male New Zealand white rabbits were used. Five of them were chosen randomly for the measurement of the distances between superior to inferior edge and exterior to interior edge of anterior naris of the right-side nasal cavity and the distance between anterior naris and maxillary ostium. The other 25 were divided into modeling group （10 rabbits）, simple blocking group （10 rabbits） and blank control group （5 rabbits）. A piece of polyvinyl acetal absorbent sponge （Merocel） in size of 2.5 mm × 5 mm × 28 mm was inserted into the right-side nasal cavity of the rabbits in both modeling and simple blocking groups. The sponges were soaked with 1 ml type Ⅲ streptococcus pneumoniae solution and 1ml sterile saline solution in modeling group and simple blocking group respectively. At the 10th day after insertion, the sinuses were examined by computed tomography scans and then all rabbits were sacrificed to obtain the secretions from the right-side maxillary and ethmoidal sinuses for culture, followed by the block remove of the right sinuses for whole-mount histological analyses. Results At the 10th day after insertion, all rabbits survived except one of modeling group died at the 4th day. In modeling group, the positive rate of bacterial culture were 100 % in secretions from both the maxillary and ethrnoidal sinuses. CT scan showed opacification of right maxillary sinuses and ethmoidal sinuses. Lumenal predominant neutrophilic leukocytes accumulation was observed under light microscope. Epithelial degeneration with ulceration in some areas, and inflammatory ceils infiltration of the mucous layer as well as the submucosa were also observed. Eight rabbits in simple blocking group had similar radiological changes, but histopathological changes were lighter in degree than those in modeling group. The results were significantly different between the two groups. Conclusion The rhinogenic model of acute sinusitis has been successfully established in the rabbits, which lays a foundation for the further researches on the pathogenesis and therapia of rhinogenic sinusitis.