鼻内窥镜术后普米克令舒鼻雾化吸入对ENaC蛋白表达的影响

Influence of nebulized Pulmicort respules inhalation after endoscopic sinus surgery on expression of ENaC protein

目的探讨鼻内窥镜术(ESS)后普米克令舒鼻雾化吸入对鼻腔黏膜上皮钠离子通道(ENaC)蛋白表达的影响。方法44例行ESS的鼻息肉患者随机分为普米克令舒治疗组(n=21)和雷诺考特对照组(n=23),治疗组术后予以普米克令舒鼻雾化吸入治疗,对照组术后予以常规雷诺考特喷鼻治疗,连续10 d。两组患者均于术后第14天鼻内窥镜下行术侧中鼻甲残端黏膜活检,术中及术后标本均于显微镜下行嗜酸性粒细胞(Eos)和中性粒细胞(Neu)计数,免疫荧光检测ENaC蛋白的表达。结果治疗后,两组Eos和Neu计数均下降,但普米克令舒治疗组Neu低于雷诺考特对照组(P<0.05);普米克令舒治疗组上皮细胞ENaC蛋白的表达也低于雷诺考特对照组(P<0.01)。结论ESS术后应用普米克令舒治疗可减少Neu的浸润,抑制ENaC蛋白的表达,有利于减轻鼻黏膜急性炎症和水肿反应。

Objective To investigate the influence of nebulized Pulmicort respules inhalation after endoscopic sinus surgery （ESS） on the expression of epithelial Na^＋ channel （ENaC） protein in nasal mucosa. Methods Forty-four patients with nasal polyps undergoing ESS were randomly divided into Pulmicort respules treatment group （n = 21, nebulized Pulmicort respules inhalation for 10 d after ESS） and Rhinocort control group （n = 23, Rhinocort aqueous nasal spray for 10 d after ESS）. All the patients were performed biopsy of membrane on the residual middle turbinate 14 d after ESS, eosinophils （Eos） and neutrophils （Neu） per hundred inflammation cells were counted under microscope during ESS and after ESS, and the expression of ENaC protein was detected by immunofluorescence assay. Results The percentages of Eos and Neu decreased in two groups after treatment, and the percentage of Neu in Pulmicort respules treatment group was significantly lower than that in Rhinocort control group （P 〈 0.05）. The expression of ENaC protein after treatment in Pulmieort respules treatment group was significantly lower than that in Rhinocort control group （P 〈 0.01）. Conclusion Application of pulmicort respules after ESS can decrease Neu infiltration and inhibit expression of ENaC protein, which can relieve acuteinflammation and edema of nasal mucosa.