糖皮质激素对老年鼻息肉患者表皮生长因子和表皮生长因子受体的表达影响及其临床作用

Effect of glucocorticoid on the nasal mucosal expression of epidermal growth factor and epidermal growth factor receptor in aged patients with nasal polyps and its clinical efficacy

目的探讨糖皮质激素治疗老年鼻息肉患者的效果及其对息肉组织中表皮生长因子(EGF)和表皮生长因子受体(EGFR)表达水平的影响。方法纳入2014年1月至2016年8月在我院接受糖皮质激素治疗的60例老年鼻息肉患者(息肉组)及鼻中隔偏曲患者20例(对照组)。息肉组患者采用布地奈德喷剂治疗12周,分别于治疗前、治疗后采集息肉组织及对照组鼻黏膜组织进行免疫组化染色及逆转录-多聚酶链反应(RT-PCR)检查,对比两组EGF和EGFR蛋白及信使核糖核酸(mRNA)表达水平。计量资料以均数±标准差表示,两组间比较采用t检验。结果息肉组患者的鼻息肉病变评分情况:治疗前(2.48±0.77)分,治疗2周后(2.11±0.68)分,治疗6周后(1.57±0.49)分,治疗12周后(1.29±0.64)分;鼻息肉病变评分呈逐渐降低趋势,各时间点比较差异具有统计学意义(P<0.05)。息肉组在治疗前、治疗后的EGF、EGFR蛋白表达水平和mRNA表达水平均高于对照组(P<0.05);息肉组治疗12周后鼻息肉组织中EGF和EGFR蛋白表达水平和mRNA表达水平较治疗前均显著降低(P<0.05)。结论糖皮质激素治疗老年鼻息肉患者的效果肯定,其作用机制与抑制鼻息肉组织中EGF及EGFR表达有关。

Objective To investigate the efficacy of glucocorticoid in treatment of nasal polyps in elderly patients and determine its effect on nasal mucosal expression of epidermal growth factor （EGF） and epidermal growth factor receptor （EGFR）.Methods A total of 60 elderly patients with nasal polyps （polyp group,budesonide nasal spray）,and 20 patients with nasal septum deviation （control group,normal saline） admitted to our hospital from January 2014 to August 2016 were enrolled in this study.The expression levels of EGF and EGFR in the nasal polyp and mucosa tissues were detected with immunohistochemical staining and RT-PCR before and 12 weeks after the treatment in the polyp group and the control group.The measurement data were expressed as mean±standard deviation （x^-±s）,and Student＇s t test was employed for the comparison between groups.Results The score of polypoid lesion in the polyp group was 2.48±0.77 before the treatment,and then declined to 2.11±0.68,1.57±0.49 and 1.29±0.64,respectively in 2,6 and 12 weeks after treatment,with significant differences between different time points （P〈0.05）.Both the protein and mRNA levels of EGF and EGFR were significantly higher in the polyp group than in the control group before and after the treatment （P〈0.05）.The glucocorticoid treatment for 12 weeks resulted in significant decreases in the protein and mRNA levels of EGF and EGFR in the polyp group （P〈0.05）.Conclusion Glucocorticoid therapy exerts curative effects on the eledrly patients with nasal polyps,which may be related to its inhibition on the expression of EGF and EGFR.