家兔急性鼻窦炎上颌窦黏膜病理改变

Pathological changes of maxillary sinus mucosa of rabbits with acute sinusitis

目的观察家兔实验性鼻源性急性鼻窦炎上颌窦黏膜超微结构及黏液纤毛传输功能的改变。方法健康成年雄性新西兰白兔15只,随机分为实验组(10只)和空白对照组(5只)。将3mm×5mm×25mm大小Merocel?高分子膨胀海绵置入实验组兔右侧鼻腔,并向高分子膨胀海绵中注射植入1mlⅢ型肺炎链球菌悬液。2周后,用印度墨汁法测定上颌窦黏液纤毛传输速度。然后处死动物,取右上颌窦黏膜通过透射电镜观察其超微结构改变。结果实验组家兔上颌窦黏液纤毛传输速度明显低于空白对照组,有极显著统计学差异(P<0.01)。实验组上颌窦黏膜在透射电镜下观察到纤毛变性、脱落,排列紊乱,可见复合纤毛、微管动力臂缺陷、胞质突起、内质网扩张、线粒体肿胀、胞浆水肿及黏膜下层淋巴细胞浸润等超微的结构改变。结论急性鼻窦炎上颌窦黏膜超微结构明显改变,黏液纤毛传输速度减慢,结构改变导致功能下降。

To observe the ultrastructure and mucociliary transport speed of maxillary sinus mucosa of experimental rhinogenic acute sinusitis in rabbits. METHODS Fifteen healthy adult male New Zealand white rabbits were divided into experimental group（10 rabbits） and blank control group（5 rabbits） randomly. For the experimental group, a piece of polyvinyl acetal absorbent sponge （Merocel） in size of 3 mmx5 mmx25 mm was inserted into the right-side nasal cavity of each rabbit. The sponges were soaked with lml type Ⅲ streptococcus pneumoniae solution. Two weeks after insertion, the mucociliary transport speed was measured by India ink solution method. All rabbits were sacrificed to obtain the right-side maxillary sinus mucosa for ultrastructure observation through transmission electron microscope. RESULTS The mucociliary transport speed of experimental group was much lower than that of blank control group, and the difference was statistically significant （P〈0.01）. Under transmission electron microscope, inordinate array and loss of cilia was observed. A few compound cilia, dynein arm defects and cytoplasmic protrusion were also found. Both endoplasmic reticulum and mitochondria were swelling. The endochylema was often edematous with lymphocytes infiltrating in the submucosa. CONCLUSION The ultrastructure changes of maxillary sinus mucosa of acute sinusitis are obvious, and mucociliary transport speed decreases markedly. Structure changes of sinus mucosa usually lead to decline of function.