本文關(guān)鍵詞： 糖皮質(zhì)激素 鼻息肉 黏膜 糖皮質(zhì)激素受體 機(jī)制　出處：《大連醫(yī)科大學(xué)》2010年碩士論文　論文類型：學(xué)位論文

【摘要】： 目的： 1.對鼻息肉患者鼻息肉組織及正常鼻腔粘膜組織中糖皮質(zhì)激素受體進(jìn)行檢測分析,并對比兩者糖皮質(zhì)激素受體分布情況,探尋其表達(dá)分布的規(guī)律性。 2.進(jìn)一步探討糖皮質(zhì)激素在鼻息肉圍手術(shù)期處理中應(yīng)用的合理性及糖皮質(zhì)激素治療鼻息肉的相關(guān)機(jī)制。 材料與方法 收集2009年1月-12月期間大連醫(yī)科大學(xué)附屬第二醫(yī)院耳鼻咽喉科門診及住院患者60例,其中30例為已確診為鼻息肉的手術(shù)患者(經(jīng)臨床檢查、取病理送檢和鼻竇CT掃描后確診為鼻息肉),取其息肉組織作為研究對象。另取30例正常人一側(cè)下鼻甲前端黏膜作為正常對照組。通過HE染色及免疫組化SP法,檢測鼻息肉和正常下鼻甲黏膜中糖皮質(zhì)激素受體的表達(dá)和分布情況。最后對實(shí)驗(yàn)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析。 結(jié)果： 糖皮質(zhì)激素受體在鼻息肉組及正常對照組中均有陽性表達(dá),主要表現(xiàn)為胞漿、胞核中出現(xiàn)淺黃色至棕褐色陽染顆粒。鼻息肉組中陽性細(xì)胞主要集中表達(dá)于鼻息肉表面的上皮細(xì)胞層、基底細(xì)胞及囊性擴(kuò)張的腺體細(xì)胞,間質(zhì)內(nèi)的血管內(nèi)皮細(xì)胞及嗜酸性粒細(xì)胞等炎性細(xì)胞也有陽性表達(dá)。正常對照組主要表達(dá)于下鼻甲黏膜上皮層及基底細(xì)胞層。對鼻息肉組和正常對照組中糖皮質(zhì)激素受體陽性細(xì)胞表達(dá)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析。經(jīng)t檢驗(yàn)顯示鼻息肉組與正常對照組存在差異性(P0.05),有統(tǒng)計(jì)學(xué)意義。 結(jié)論： 1.糖皮質(zhì)激素治療是鼻息肉圍手術(shù)期處理的重要組成部分。通過檢測鼻息肉組織中糖皮質(zhì)激素受體的表達(dá)情況,可以指導(dǎo)臨床合理使用糖皮質(zhì)激素。 2.鼻息肉組織中糖皮質(zhì)激素受體的表達(dá)水平可能是影響糖皮質(zhì)激素治療效果的關(guān)鍵性因素,即糖皮質(zhì)激素受體的數(shù)量,可能決定著糖皮質(zhì)激素的治療效應(yīng)。 3.通過對糖皮質(zhì)激素活化鼻息肉組織中糖皮質(zhì)激素受體作用的進(jìn)一步研究有助于揭示糖皮質(zhì)激素治療鼻息肉的詳細(xì)機(jī)制。
[Abstract]:Objective:. 1. The glucocorticoid receptors in nasal polyps and normal nasal mucosa were detected and analyzed, and the distribution of glucocorticoid receptors in nasal polyps and normal nasal mucosa were compared to find out the regularity of the expression and distribution of glucocorticoid receptors. 2. To further explore the rationality of glucocorticoid in the perioperative treatment of nasal polyps and the related mechanism of glucocorticoid in the treatment of nasal polyps. Materials and methods. From January 2009 to December, 60 outpatients and inpatients of the Department of Otorhinolaryngology, second affiliated Hospital of Dalian Medical University were collected. Among them, 30 cases were diagnosed as surgical patients with nasal polyps. The nasal polyp was diagnosed by pathological examination and CT scan of paranasal sinuses, and the tissue of nasal polyp was taken as the study object. The mucosa of the anterior part of inferior turbinate of 30 normal people was taken as the normal control group. The mucosa was stained by HE and SP immunohistochemical method. The expression and distribution of glucocorticoid receptors in nasal polyps and normal inferior turbinate mucosa were detected. Results:. The expression of glucocorticoid receptor was positive in nasal polyp group and normal control group. In the nasal polyp group, the positive cells were mainly expressed in the epithelial cell layer, basal cells and cystic dilated gland cells on the surface of nasal polyps. The vascular endothelial cells and eosinophilic granulocytes in the interstitial tissue were also positive. The normal control group was mainly expressed in the epithelial layer and basal cell layer of the inferior turbinate mucous membrane. In the nasal polyp group and the normal control group, the glucocorticoid was stimulated. The difference between nasal polyp group and normal control group was significant (P 0.05). Conclusion:. 1. Glucocorticoid therapy is an important part of perioperative management of nasal polyps, and the expression of glucocorticoid receptors in nasal polyps can be detected to guide the rational use of glucocorticoids in clinical practice. 2. The expression level of glucocorticoid receptor in nasal polyps may be the key factor affecting the effect of glucocorticoid therapy, that is, the quantity of glucocorticoid receptor may determine the therapeutic effect of glucocorticoid. 3. Further study on glucocorticoid receptor activation in nasal polyps is helpful to reveal the mechanism of glucocorticoid in the treatment of nasal polyps.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類號(hào)】：R765

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