鼻息肉中的炎症及组织重塑.docVIP

  鼻息肉中的炎症及组织重塑# 周鹏1，杨柳1，曾帆2* （1. 四川大学华西临床医学院耳鼻咽喉头颈外科； 5 10 15 20 25 30 2. 四川大学华西临床医学院感染疾病中心） 摘要：慢性鼻窦炎（CRS）目前分为两个亚类：CRS 伴鼻息肉和 CRS 不伴鼻息肉。研究已 发现各种自由基介质，包括细胞因子和趋化因子、粘附分子、基质金属蛋白酶在这两个亚组 中均上调。提示两个亚组均存在组织重构，但也有特异性差异。CRS 不伴鼻息肉有更多的 嗜中性粒细胞渗透，CRS 伴鼻息肉（尤其是当伴有过敏/哮喘）中嗜酸性粒细胞浸润显着增 加。虽然两组 CRS 中均能发现几种典型的组织重塑，例如：鳞状上皮化生、基底膜增厚、 胶原沉积、粘液腺增生、杯状细胞，然而却在两组中均没发现如同哮喘病人的呼吸道上皮脱 落现象。此外，假性囊肿也只在 CRS 伴鼻息肉这组中出现。由于炎症及组织重塑贯穿了鼻 息肉发生发展的过程，必须更加深入的对其进行研究。 关键词：鼻息肉；炎症；组织重塑。 中图分类号：R765.4 Inflammation and remodeling in nasal polyps Zhou Peng1, Yang Liu1, Zeng Fan2 (1. Department Of Otolaryngology Head and neck surgery, West China medical School, Sichuan University, Cheng Du 610000; 2. Infectious Disease Center, West China medical School, Sichuan University,Cheng Du 610000) Abstract: Chronic rhinosinusitis (CRS) is currently divided into two sub-categories: CRS with nasal polyps and CRS without nasal polyps. Studies have found a variety of radical media, including cytokines and chemokines, adhesion molecules, matrix metalloproteinases in both subgroups were raised. Tip two subgroups exist in tissue remodeling, but there are specific differences. CRS without nasal polyps have more neutrophil infiltration, CRS with nasal polyps (especially when accompanied by an allergy/asthma) a significant increase in eosinophil infiltration.. Although both groups are able to find several typical CRS in tissue remodeling, such as: squamous metaplasia, basement membrane thickening, collagen deposition, mucus gland hyperplasia, goblet cells, yet were not found in the two groups as asthma airway epithelial shedding. In addition, pseudocysts CRS polyps only in this group appear. Due to inflammation and tissue remodeling occurs throughout the course of the development of polyps and must be studied more and deep. Key words: Nasal Polyps; Inflammation; Remodeling 35 0 引言 鼻窦炎定义为一组炎症累及鼻和鼻窦的器质性病变，是一种最常见的上呼吸道疾病。同 时也是全球一个主要的健康问题[1]。基于国际共识，鼻窦炎的分类为急性细菌性鼻窦炎、 慢性鼻窦炎（CRS）和变应性真菌性鼻窦炎[2]。CRS 定义为症状持续时间超过 12 周，其具 40 有较高的发病率和较低的生活质量。CRS 可细分为两组：C