本文選題：鼻息肉 + 嗜酸性粒細(xì)胞��； 參考：《青島大學(xué)》2012年碩士論文

【摘要】：第一部分不同時期鼻息肉組織中炎性細(xì)胞的觀察和比較 目的觀察近八年中不同年份鼻息肉組織中炎性細(xì)胞的分布情況,尤其是嗜酸性粒細(xì)胞的浸潤情況與數(shù)量變化,探討不同時期鼻息肉的組織病理學(xué)變化,可能的影響因素及其與治愈時間的關(guān)系。 方法所有鼻息肉標(biāo)本均來自青島大學(xué)醫(yī)學(xué)院耳鼻喉科的住院患者,并對這些患者的臨床資料進(jìn)行回顧性分析。選取2004年1月—2011年12月共8個年份的鼻息肉標(biāo)本,每年20例,共160例,其中男122例,女38例,年齡19—79歲。按照中華醫(yī)學(xué)會關(guān)于變應(yīng)性鼻炎的診斷標(biāo)準(zhǔn),對患者進(jìn)行臨床類型的分型。所有患者均排除支氣管哮喘、鼻部良惡性腫瘤、囊性纖維化、不動纖毛綜合征、真菌性鼻竇炎等相關(guān)性疾病,并排除明顯解剖異常,且所有患者術(shù)前一周未行抗生素、未經(jīng)口或鼻給予皮質(zhì)類固醇激素等藥物治療。 對160例鼻息肉標(biāo)本進(jìn)行HE染色,光學(xué)顯微鏡下每張切片選取5個高倍視野(×400),手工計數(shù)嗜酸性粒細(xì)胞、淋巴細(xì)胞、中性粒細(xì)胞個數(shù),并根據(jù)鼻息肉組織中嗜酸性粒細(xì)胞的個數(shù)進(jìn)行組織學(xué)類型劃分,將標(biāo)本分為嗜酸性粒細(xì)胞浸潤型和非嗜酸性粒細(xì)胞浸潤型。計算出不同年份、不同臨床類型、不同組織學(xué)類型鼻息肉標(biāo)本中三種炎性細(xì)胞的平均值,并進(jìn)行方差分析、兩兩比較及t檢驗；同時對160例鼻息肉患者的治愈時間、嗜酸性粒細(xì)胞數(shù)、淋巴細(xì)胞數(shù)及中性粒細(xì)胞數(shù)進(jìn)行相關(guān)性分析。 結(jié)果不同年份鼻息肉組織中,平均嗜酸性粒細(xì)胞數(shù)的差異無統(tǒng)計學(xué)意義(F=1.961,P0.05),數(shù)目呈現(xiàn)波狀變化趨勢,以2009年數(shù)目最多,2011年和2007年次之；淋巴細(xì)胞和中性粒細(xì)胞平均值亦無統(tǒng)計學(xué)差異(P0.05)。不同臨床類型、不同組織學(xué)類型間平均嗜酸性粒細(xì)胞數(shù)存在統(tǒng)計學(xué)差異(P0.01),而平均淋巴細(xì)胞數(shù)、中性粒細(xì)胞數(shù)無統(tǒng)計學(xué)差異(P0.05)。 不同組織學(xué)類型中,嗜酸性粒細(xì)胞浸潤型鼻息肉中,嗜酸性粒細(xì)胞數(shù)最多,淋巴細(xì)胞次之,中性粒細(xì)胞最少；在非嗜酸性粒細(xì)胞浸潤型組織中,淋巴細(xì)胞數(shù)最多,隨后是嗜酸性粒細(xì)胞和中性粒細(xì)胞。嗜酸性粒細(xì)胞浸潤型患者治愈時間明顯長于非嗜酸性粒細(xì)胞浸潤型患者(t=17.552,P0.01),嗜酸性粒細(xì)胞數(shù)與治愈時間呈正相關(guān)(r=0.255,P0.01),其與淋巴細(xì)胞數(shù)呈負(fù)相關(guān)(r=—0.199,P0.05),中性粒細(xì)胞數(shù)與嗜酸性粒細(xì)胞、淋巴細(xì)胞的相關(guān)性無統(tǒng)計學(xué)意義(P0.05)。 結(jié)論鼻息肉組織中,嗜酸性粒細(xì)胞數(shù)在近八年中未呈現(xiàn)明顯增加或減少的變化趨勢,其中2009年數(shù)目最多,2011年和2007年次之；淋巴細(xì)胞和中性粒細(xì)胞數(shù)目亦無明顯變化。不同臨床類型、不同組織學(xué)類型的患者,其鼻息肉組織中浸潤的炎性細(xì)胞有所不同。嗜酸性粒細(xì)胞浸潤型患者治愈時間明顯長于非嗜酸性粒細(xì)胞浸潤型患者,且嗜酸性粒細(xì)胞浸潤越多,患者治愈時間越長。根據(jù)組織中炎性細(xì)胞浸潤的特點對鼻息肉進(jìn)行分類,可能對了解疾病發(fā)病機制,指導(dǎo)治療及預(yù)后有一定意義。 第二部分 不同時期鼻息肉組織中趨化因子eotaxin和RANTES的表達(dá)和意義 目的觀察近八年中不同年份鼻息肉組織中趨化因子eotaxin和RANTES的表達(dá)情況,探討其在不同時期鼻息肉組織中的表達(dá)意義和變化趨勢,及其與嗜酸性粒細(xì)胞的相關(guān)性。 方法所有鼻息肉標(biāo)本均來自青島大學(xué)醫(yī)學(xué)院耳鼻喉科的住院患者,選取2004年1月—2011年12月共8個年份的鼻息肉標(biāo)本,每年5例,共40例,其中男28例,女12例,年齡21—78歲。對40例鼻息肉標(biāo)本進(jìn)行HE染色和免疫組織化學(xué)染色,光學(xué)顯微鏡下計數(shù)嗜酸性粒細(xì)胞數(shù)目并檢測趨化因子eotaxin和RANTES的平均光密度值(AOD)。根據(jù)嗜酸性粒細(xì)胞個數(shù),對鼻息肉進(jìn)行組織學(xué)類型劃分。計算出不同年份鼻息肉標(biāo)本中嗜酸性粒細(xì)胞的平均值,以及eotaxin和RANTES的光密度值,進(jìn)行方差分析、兩兩比較、t檢驗及相關(guān)性分析。 結(jié)果不同年份鼻息肉組織中嗜酸性粒細(xì)胞數(shù)、eotaxin和RANTES的光密度值均有統(tǒng)計學(xué)差異(P0.05),并呈現(xiàn)逐年增加趨勢,兩兩比較發(fā)現(xiàn),04年與09、10、11年平均值存在統(tǒng)計學(xué)差異(P0.05),其余年份兩兩比較后差異無統(tǒng)計學(xué)意義(P0.05)。不同組織學(xué)類型間,嗜酸性粒細(xì)胞數(shù)、eotaxin和RANTES的光密度值亦存在統(tǒng)計學(xué)差異(P0.001),且嗜酸性粒細(xì)胞數(shù)與eotaxin、RANTES表達(dá)量呈正相關(guān)(P0.05)。 結(jié)論在近八年的鼻息肉組織中,嗜酸性粒細(xì)胞數(shù)目、eotaxin表達(dá)量、RANTES表達(dá)量均呈現(xiàn)逐年上升的動態(tài)趨勢,且不同組織學(xué)類型的患者,其趨化因子的表達(dá)量存在差異,嗜酸性粒細(xì)胞浸潤型患者的eotaxin、RANTES表達(dá)量明顯多于非嗜酸性粒細(xì)胞浸潤型患者,且二者表達(dá)量越多,嗜酸性粒細(xì)胞浸潤越多。該研究對了解鼻息肉中嗜酸性粒細(xì)胞浸潤機制及指導(dǎo)臨床治療有一定意義。
[Abstract]:The first part is the observation and comparison of inflammatory cells in nasal polyps at different stages.
Objective To observe the distribution of inflammatory cells in nasal polyps in different years, especially the infiltration and quantity of eosinophils, and to explore the histopathological changes of nasal polyps in different periods, the possible influencing factors and the relationship with the cure time.
Methods all the nasal polyps were from the hospitalized patients in the Department of ENT of the Medical College of Qiingdao University, and the clinical data of these patients were analyzed retrospectively. The specimens of nasal polyps in 8 years from January 2004 to December 2011 were selected, 20 cases each year, including 160 cases, including 122 male, 38 female, 19 to 79 years old. All patients excluded bronchial asthma, benign and malignant tumors of the nose, cystic fibrosis, ciliated syndrome, fungal sinusitis and other related diseases, and excluded obvious anatomic abnormalities, and all patients were not given antibiotics one week before operation, without oral or nasal administration. Steroid hormones such as drug treatment.
160 cases of nasal polyps were stained with HE, and 5 high times of visual field (x 400) were selected for each slice under optical microscope. The number of eosinophils, lymphocytes and neutrophils were counted by hand, and the histological types were divided according to the number of eosinophils in the nasal polyps. The specimens were divided into eosinophil infiltrating and non eosinophils. The average value of three kinds of inflammatory cells in different years, different clinical types and different histological types of nasal polyps were calculated, and the variance analysis, 22 comparison and t test were carried out. At the same time, the cure time, the number of eosinophils, the number of lymphocyte and the number of neutrophils in 160 cases of nasal polyps were related. Sex analysis.
Results the average number of eosinophils in the nasal polyps in different years was not statistically significant (F=1.961, P0.05), and the number showed a wave change trend, which was the largest in 2009, in 2011 and 2007. The mean value of lymphocyte and neutrophils was not statistically different (P0.05). Different clinical types and different histological types were found. There was a significant difference in mean eosinophil count (P0.01), but there was no significant difference in mean lymphocyte count and neutrophil count (P0.05).
Among the different histological types, eosinophil infiltrated nasal polyps were the most eosinophil and the least neutrophils. In the non eosinophilic granulocyte infiltrating tissue, the number of lymphocytes was the most, followed by eosinophils and neutrophil cells. The cure time of eosinophil infiltrating patients was obvious. There was a positive correlation between the number of eosinophils and the cure time (r=0.255, P0.01). The number of eosinophils was negatively correlated with the number of lymphocytes (r= 0.199, P0.05), the number of neutrophils and eosinophils, and there was no statistically significant correlation between the number of neutrophils and lymphocytes (P0.05), which was longer than t=17.552 (P0.01).
Conclusion the number of eosinophils in nasal polyps has not been significantly increased or decreased in the last eight years. The number of eosinophils in 2009 is the most, in 2011 and 2007. There is no obvious change in the number of lymphocytes and neutrophils. Patients with different clinical types, different histological types, and infiltrating inflammation in their nasal polyps The cure time of eosinophil infiltrating type patients is significantly longer than that of non eosinophil infiltrating patients, and the more eosinophil infiltration, the longer the patient is cured. The classification of nasal polyps according to the characteristics of inflammatory cell infiltration in the tissue may be to understand the pathogenesis, guide treatment and prognosis of the disease. It is of certain significance.
The second part
Expression and significance of chemokine eotaxin and RANTES in nasal polyps at different stages
Objective To observe the expression of chemokine eotaxin and RANTES in nasal polyps in different years in different years, and to explore the significance and trend of its expression in nasal polyps at different stages and the correlation with eosinophils.
Methods all the nasal polyps were from the hospitalized patients in the Department of ENT of the Medical College of Qiingdao University and selected the nasal polyps in 8 years from January 2004 to December 2011. There were 5 cases each year. There were 40 cases, including 28 male, 12 female, 21 to 78 years old. 40 cases of nasal polyps were stained with HE and immunohistochemical staining, and counted under optical microscope. The number of eosinophils and the average optical density value (AOD) of chemokine eotaxin and RANTES were measured. According to the number of eosinophils, the histological types of nasal polyps were divided. The average value of eosinophils in nasal polyps in different years, and the light density values of eotaxin and RANTES were calculated, and the variance analysis was carried out, 22 comparison, T test and correlation analysis.
Results the number of eosinophils, eotaxin and RANTES in different years of nasal polyps were statistically different (P0.05), and showed an increasing trend year by year. 22 compared with the average value of 04 years and 09,10,11 years, there was statistical difference (P0.05), and the difference between the other years 22 after the comparison was not statistically significant (P0.05). There were also statistical differences (P0.001) between the number of eosinophils, eotaxin and RANTES, and the number of eosinophils was positively correlated with the expression of eotaxin and RANTES (P0.05).
Conclusion in the recent eight years, the number of eosinophils, the expression of eotaxin and the expression of RANTES in the nasal polyps were increasing year by year, and the expression of chemokine in the patients with different histology types was different. The expression of eotaxin in eosinophil infiltrating patients was more than that of non eosinophilic granules. The more expression of the two patients, the more eosinophil infiltration is more. This study is of certain significance to understand the mechanism of eosinophil infiltration in nasal polyps and to guide clinical treatment.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R765.25

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