【摘要】：背景與目的：慢性鼻-鼻竇炎(chronic rhinosinusitis,CRS)是鼻腔粘膜的慢性炎癥，是耳鼻喉科最常見(jiàn)的疾病之一。補(bǔ)體是一組參與炎癥及免疫反應(yīng)發(fā)揮一定生物學(xué)效應(yīng)的蛋白，近年來(lái)補(bǔ)體活化在慢性鼻-鼻竇炎發(fā)病中的作用越來(lái)越受到人們重視。補(bǔ)體調(diào)節(jié)蛋白(complementregulatoryproteins，CRP)可抑制補(bǔ)體活化對(duì)自身組織的損傷，在補(bǔ)體調(diào)節(jié)過(guò)程中起著主要的作用，人體血細(xì)胞、血管內(nèi)皮細(xì)胞、黏膜上皮細(xì)胞等多種組織細(xì)胞可表達(dá)補(bǔ)體調(diào)節(jié)蛋白。補(bǔ)體調(diào)節(jié)蛋白以特定的方式與補(bǔ)體系統(tǒng)的不同成分相互作用，使補(bǔ)體的激活和抑制處于精細(xì)的平衡狀態(tài)，從而防止對(duì)宿主自身組織造成損害。其中CD55、CD59是目前在呼吸道粘膜免疫中研究得較多的膜結(jié)合CRP。]研究發(fā)現(xiàn)鼻息肉患者鼻腔粘膜分泌物中有高濃度的C3a和C5a，提示鼻息肉患者鼻腔粘膜局部也有補(bǔ)體活化，并參與鼻息肉的發(fā)病機(jī)制中。但對(duì)于慢性鼻-鼻竇炎患者CD55和CD59的表達(dá)水平尚未見(jiàn)報(bào)道。本研究通過(guò)觀(guān)察CD55，CD59在慢性鼻-鼻竇炎組織中的表達(dá)。探討其與慢性鼻-鼻竇炎發(fā)病的關(guān)系。 方法：選取2011年7月至2012年7月行鼻竇內(nèi)窺鏡手術(shù)的慢性鼻竇炎患者60例，分為單純炎癥組和合并鼻息肉組，手術(shù)切除上頜竇開(kāi)口處黏膜。并以30例單純行鼻中隔偏曲矯正手術(shù)患者為對(duì)照組，對(duì)照組粘膜標(biāo)本來(lái)自行鼻中隔手術(shù)患者鼻道-竇口復(fù)合體黏膜。采用免疫組織化學(xué)方法檢測(cè)三組患者鼻腔黏膜及鼻息肉組織中CD55和CD59的表達(dá)情況。結(jié)果：CD55和CD59在對(duì)照組及鼻竇炎鼻息肉組織中均有表達(dá)，二者在對(duì)照組的表達(dá)高于鼻竇炎鼻息肉組織（P0.05，P0.01）。與單純炎癥組相比，，合并鼻息肉組CD55和CD59表達(dá)進(jìn)一步下降（P0.05）。結(jié)論:慢性鼻竇炎鼻息肉患者鼻腔黏膜CD55、CD59的表達(dá)降低，提示補(bǔ)體調(diào)節(jié)蛋白表達(dá)下降，進(jìn)而導(dǎo)致補(bǔ)體活化，可能參與慢性鼻-鼻竇炎發(fā)病機(jī)制。
[Abstract]:Background & objective: chronic rhinosinusitis (chronic rhinosinusitis,CRS) is a chronic inflammation of nasal mucosa and one of the most common diseases in Otolaryngology. Complement is a group of proteins that play a biological role in inflammation and immune response. In recent years, the role of complement activation in the pathogenesis of chronic rhinosinusitis has been paid more and more attention. Complement regulatory protein (complementregulatoryproteins,CRP) can inhibit the injury of complement activation to its own tissue and play a major role in complement regulation. Human blood cells and vascular endothelial cells play an important role in the process of complement regulation. Many tissue cells, such as mucosal epithelial cells, can express complement regulatory proteins. Complement regulatory proteins interact with different components of the complement system in a specific way, which makes complement activation and inhibition in a fine equilibrium state, thus preventing damage to host tissues. Among them, CD55,CD59 is a membrane-bound CRP. which has been widely studied in respiratory mucosal immunity.] It was found that there were high concentrations of C3a and C5a in nasal mucosa secretions in patients with nasal polyps, suggesting that complement activation was also found in nasal mucosa of patients with nasal polyps and involved in the pathogenesis of nasal polyps. However, the expression of CD55 and CD59 in patients with chronic rhinosinusitis has not been reported. In this study, we observed the expression of CD55,CD59 in chronic rhinosinusitis. To explore the relationship between chronic rhinosinusitis and chronic rhinosinusitis. Methods: 60 patients with chronic sinusitis who underwent endoscopic sinus surgery from July 2011 to July 2012 were divided into two groups: simple inflammation group and nasal polyps group. 30 cases of nasal septum deviation correction were taken as the control group, and the mucosa specimens of the control group were from the nasal meatus-sinus complex mucosa of the patients undergoing nasal septum surgery. Immunohistochemical method was used to detect the expression of CD55 and CD59 in nasal mucosa and nasal polyps. Results: the expression of CD55 and CD59 was higher in the control group than in the sinusitis and nasal polyp tissue (P0.05, P0.01), and the expression of both of them was higher in the control group than in the sinusitis and nasal polyp tissue (P 0.05, P0.01). Compared with simple inflammation group, the expression of CD55 and CD59 decreased further in nasal polyp group (P0.05). Conclusion: the decreased expression of CD55,CD59 in nasal mucosa of patients with chronic sinusitis and nasal polyps suggests that the decreased expression of complement regulatory protein leads to complement activation, which may be involved in the pathogenesis of chronic rhinosinusitis.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R765.41

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