鼻息肉手术疗效及术后鼻腔黏膜转归与嗜酸性粒细胞局部浸润的相关性探讨

The relationship between eosinophilic granulocyte infiltration and recovering process of nasal mucosa after the surgery for nasal polyps

目的探讨嗜酸性粒细胞局部浸润程度对鼻息肉手术疗效及术后鼻腔黏膜转归的影响。方法鼻息肉患者50例,分别于鼻内镜术中取息肉组织标本及术后恢复期取上颌窦口周边水肿黏膜标本备检;另取20例正常志愿者中鼻甲黏膜组织标本作为对照。Chromotrope 2R特染法检测标本嗜酸性粒细胞浸润程度,分析评价其浸润程度对术后鼻腔黏膜恢复过程的影响。结果鼻息肉组织中嗜酸性粒细胞浸润程度显著高于中鼻甲黏膜组织(P<0.01),且随时间进程而呈现不同的变化规律。嗜酸性粒细胞浸润程度越明显,鼻腔黏膜恢复过程越慢,鼻息肉复发越快。结论局部黏膜的嗜酸性粒细胞浸润在鼻息肉的形成和发展中起重要作用,可能延迟术后鼻窦、鼻腔黏膜的上皮化进程而影响手术疗效。

Objective To investigate the relationship between eosinophilic granulocyte infiltr ration and recovering process of nasal mucosa after the surgery for nasal polyps based on a study carried out in a group of clinically collected samples. Methods Included in this study were 50 cases with nasal polyps treated by nasal endoscopic surgery, with their polyp samples collected during the operation and the swollen mucosa tissue samples around the ostium margin of maxillary sinus collected during the recovering period for assaying and with the tissue samples taken from the middle turbinate among another 20 healthy volunteers as controls.Then,special Chromotrope 2R staining procedures were performed to these samples to detect the infiltrating status of eosinophilic granulocytes for evaluating its effect on the recovering process of nasal mucosa following the surgery. Results The infiltrating cell number of eosinophilic granulocytes was significantly higher in the tissue samples of nasal polyps than that in the middle turbinate（P〈0.01）,with a varying tendency in the infiltrating status with the proceeding of recovering process.It was shown from these data that the more significant the eosinophilic granulocyte infiltration,the more slowly the recovering process of the nasal mucosa and the more quickly the reoccurring of nasal polyps following the surgery. Conclusions Eosinophilic granulocyte infiltration in local mucosa may take a very important part in the Pathogenesis of nasal polyps forming and developing,and it is possible to postpone the proceeding process of epithelialization on the mlucosa of nasal cavity and sinus to give effects on the therapeutic effectiveness in turn following surgical therapy, when such a pathohistological condition becomes more obvious.