本文選題：鼻息肉　切入點：IL-5　出處：《貴州醫(yī)科大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:通過研究鼻息肉患者應(yīng)用丙酸氟替卡松鼻噴劑治療前后及正常下鼻甲組織中嗜酸性粒細胞浸潤程度、IL-5(白細胞介素-5)、GM-CSF(粒細胞-巨噬細胞集落刺激因子)表達的差異性,了解鼻息肉形成中嗜酸性粒細胞浸潤程度與IL-5、GM-CSF表達的作用之間的關(guān)系,及鼻用激素對鼻息肉組織的影響,進一步揭示鼻用糖皮質(zhì)激素治療鼻息肉的作用機制及其在臨床中的應(yīng)用意義。方法:采用免疫組化和計算機圖像定量分析法,檢測應(yīng)用丙酸氟替卡松鼻噴劑前后鼻息肉組織及正常下鼻甲組織中IL-5和GM-CSF的表達;采用HE染色法檢測應(yīng)用丙酸氟替卡松鼻噴劑前后鼻息肉組織及正常下鼻甲組織中嗜酸性粒細胞浸潤程度;把每個鼻息肉組織測得的IL-5、GM-CSF(包括應(yīng)用丙酸氟替卡松鼻噴劑前后)分別與其嗜酸性粒細胞浸潤程度繪制成散點圖進行相關(guān)性分析。結(jié)果:1.鼻息肉組織中IL-5、GM-CSF的表達和嗜酸性粒細胞侵潤程度均增高,與正常下鼻甲組織比較,P0.01,差異具有統(tǒng)計學(xué)意義;2.鼻息肉患者應(yīng)用丙酸氟替卡松鼻噴劑前后對比,IL-5及GM-CSF的表達量和嗜酸性粒細胞浸潤程度均明顯減少,兩兩比較,P0.01差異具有統(tǒng)計學(xué)意義;3.鼻息肉組織中IL-5、GM-CSF的表達與嗜酸性粒細胞浸潤程度呈正相關(guān)(應(yīng)用丙酸輔替卡松鼻噴劑前后IL-5的表達與嗜酸性粒細胞浸潤程度相關(guān)系數(shù)r=0.709、p0.01,r=0.877、p0.01;應(yīng)用丙酸氟替卡松鼻噴劑前后GM-CSF的表達與嗜酸性粒細胞浸潤程度相關(guān)系數(shù)r=0.723、p0.01,r=0.959、p0.01)。結(jié)論:1.鼻息肉組織中IL-5和GM-CSF蛋白均呈高表達,且其嗜酸性粒細胞浸潤程度也增高,表明二者可增加嗜酸性粒細胞浸潤,可能在鼻息肉的形成過程中起一定作用;2.鼻息肉患者在應(yīng)用丙酸氟替卡松鼻噴劑后,鼻息肉組織中IL-5及GM-CSF的表達量均明顯減少,表明丙酸輔替卡松鼻噴劑可以有效的控制鼻息肉組織中IL-5及GM-CSF的表達,從而減少嗜酸性粒細胞的浸潤,抑制鼻息肉的發(fā)展;3.進一步解釋了臨床上鼻息肉術(shù)前應(yīng)用丙酸氟替卡松鼻噴劑,可減輕炎癥反應(yīng),防止術(shù)中出血,降低手術(shù)難度。
[Abstract]:Objective: to study the expression of IL-5 (interleukin-5) (IL-5) in patients with nasal polyps before and after treatment with fluticasone propionate nasal spray and in normal inferior turbinate tissues, and the expression of IL-5 (granulocyte-macrophage colony stimulating factor) was detected. To investigate the relationship between eosinophil infiltration and IL-5 GM-CSF expression in nasal polyps and the effect of nasal hormones on nasal polyps. To further reveal the mechanism of nasal glucocorticoid in the treatment of nasal polyps and its clinical significance. Methods: immunohistochemistry and computer image quantitative analysis were used to analyze the effect of glucocorticoid on nasal polyps. The expression of IL-5 and GM-CSF in nasal polyps and normal inferior turbinate was detected before and after fluticasone propionate nasal spray. Eosinophil infiltration in nasal polyps and normal inferior turbinate was detected by HE staining before and after fluticasone propionate nasal spray. The relationship between IL-5 GM-CSF (including before and after fluticasone propionate nasal spray) and the degree of eosinophil infiltration in each nasal polyp was plotted to analyze the correlation between IL-5 GM-CSF and eosinophilic granulocyte infiltration degree. Results: 1. Expression of IL-5 and GM-CSF in nasal polyps. The degree of eosinophilic granulocyte invasion increased, Compared with the normal inferior turbinate tissue, the difference was statistically significant. The expression of IL-5 and GM-CSF and the degree of eosinophil infiltration in nasal polyps were significantly decreased before and after the application of fluticasone propionate nasal spray. The expression of IL-5 and GM-CSF in nasal polyps was positively correlated with the degree of eosinophil infiltration (the expression of IL-5 and the degree of eosinophil infiltration before and after nasal spray with tikassone propionate) were positively correlated with the expression of IL-5 GM-CSF in nasal polyps. The correlation coefficient between the expression of GM-CSF and the degree of eosinophil infiltration before and after the application of fluticasone propionate nasal spray was 0. 709, p0. 01. Conclusion 1. The expression of IL-5 and GM-CSF protein were highly expressed in nasal polyps. The degree of eosinophil infiltration was also increased, indicating that both of them could increase eosinophil infiltration, which might play a role in the formation of nasal polyps. 2. After the application of fluticasone propionate nasal spray, the patients with nasal polyps may play a role in the formation of nasal polyps. The expression of IL-5 and GM-CSF in nasal polyps was significantly decreased, which indicated that the expression of IL-5 and GM-CSF in nasal polyps could be effectively controlled by propionic acid and tikassone nasal spray, thus reducing the infiltration of eosinophils. It is further explained that the application of fluticasone propionate nasal spray before operation of nasal polyps can reduce inflammation, prevent intraoperative bleeding and reduce the difficulty of operation.
【學(xué)位授予單位】：貴州醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R765.25
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本文編號：1624549