【摘要】：目的:采取免疫組化的方法,通過(guò)觀察DJ-1蛋白在慢性鼻竇炎及鼻息肉中的表達(dá)情況來(lái)研究DJ-1蛋白與慢性鼻竇炎和鼻息肉發(fā)病與預(yù)后以及與中醫(yī)證型相關(guān)性。材料和方法:本課題采用免疫組化實(shí)驗(yàn)的方法,于臨床上篩選70例慢性鼻竇炎、53例鼻息肉及28例難治性慢性鼻-鼻竇炎病變組織與20例正常鼻黏膜組織石蠟標(biāo)本,分別檢測(cè)其中DJ-1蛋白的表達(dá)情況。根據(jù)患者病史、癥狀、體征,結(jié)合中醫(yī)望、聞、問(wèn)、切四診,對(duì)患者進(jìn)行辨證分型,運(yùn)用X2檢驗(yàn)統(tǒng)計(jì)分析DJ-1蛋白與慢性鼻竇炎和鼻息肉發(fā)病與預(yù)后以及與中醫(yī)證型相關(guān)性。結(jié)果:(1)DJ-1蛋白表達(dá)于鼻黏膜上皮、腺上皮、杯狀細(xì)胞的細(xì)胞胞漿和胞核中;(2)慢性鼻竇炎、鼻息肉及難治性慢性鼻-鼻竇炎和正常鼻黏膜組織之間DJ-1蛋白陽(yáng)性強(qiáng)度是有顯著性差異的(X2=148.002,P㩳0.001)。其中慢性鼻竇炎的陽(yáng)性強(qiáng)度以“+++”為主,鼻息肉的陽(yáng)性強(qiáng)度以“+”為主,難治性慢性鼻-鼻竇炎組織的陽(yáng)性強(qiáng)度以“-~+”為主,而正常鼻黏膜組織陽(yáng)性強(qiáng)度以“++”為主;(3)慢性鼻竇炎膽腑郁熱型、脾胃濕熱型、肺氣虛寒型和脾氣虛弱型DJ-1蛋白陽(yáng)性強(qiáng)度構(gòu)成比無(wú)明顯差異(X2=4.407,P=0.6220.05);鼻息肉寒濕凝聚與濕熱蘊(yùn)結(jié)型DJ-1蛋白陽(yáng)性強(qiáng)度構(gòu)成比亦無(wú)明顯差異(X2=0.008,P=0.9350.05)。結(jié)論:本次免疫組化研究發(fā)現(xiàn)DJ-1蛋白在慢性鼻竇炎組織中表達(dá)最高,而在鼻息肉中表達(dá)較低,從這一點(diǎn)也可以認(rèn)為慢性鼻竇炎與鼻息肉是兩個(gè)相對(duì)獨(dú)立的疾病或者是同一疾病的不同發(fā)展階段。DJ-1蛋白的表達(dá)差異對(duì)慢性鼻竇炎及鼻息肉的發(fā)病及預(yù)后有著重要的作用。DJ-1蛋白在慢性鼻竇炎和鼻息肉各證型中的表達(dá)情況無(wú)顯著性差異,原因可能是中醫(yī)的辨證分型帶有一定主觀性或者患者證型可隨外邪內(nèi)因發(fā)生改變;另一方面,可能因?yàn)闃颖玖枯^小,若將來(lái)擴(kuò)大樣本量研究,也許會(huì)獲得不同的結(jié)果。
[Abstract]:Objective: to observe the expression of DJ-1 protein in chronic sinusitis and nasal polyps by immunohistochemical method to study the relationship between DJ-1 protein and chronic sinusitis and nasal polyps and the prognosis of chronic sinusitis and nasal polyps. Materials and methods: in this study, 70 cases of chronic sinusitis and 53 cases of nasal polyps, 28 cases of refractory chronic rhinosinusitis and 20 cases of normal nasal mucosa were selected by immunohistochemical method. The expression of DJ-1 protein was detected. According to the history, symptoms and signs of the patients, combined with traditional Chinese medicine, smell, ask, cut four diagnosis, the patients were differentiated and classified, using X2 test statistical analysis of the DJ-1 protein and chronic sinusitis and nasal polyps, and the relationship between the pathogenesis and prognosis and TCM syndromes. Results: (1) DJ-1 protein was expressed in cytoplasm and nucleus of nasal mucosa epithelium, glandular epithelium, goblet cells, (2) chronic sinusitis, The positive intensity of DJ-1 protein was significantly different between nasal polyps and refractory chronic rhinosinusitis and normal nasal mucosa. The positive intensity of chronic sinusitis was mainly ", the positive intensity of nasal polyps was", and the positive intensity of refractory chronic rhinosinusitis was "-~". The positive intensity of normal nasal mucosa was mainly ". (3) chronic sinusitis, damp-heat type of spleen and stomach, There was no significant difference in the positive intensity ratio of DJ-1 protein between the lung qi deficiency cold type and the weak temper type (X2P 4.407), and there was no significant difference in the ratio of DJ-1 positive intensity between the cold and wet condensation type and the damp-heat accumulation type of nasal polyp (X2 0. 008 PJ 0. 935 05). Conclusion: the expression of DJ-1 protein was the highest in chronic sinusitis and low in nasal polyps. From this point, it can be concluded that chronic sinusitis and nasal polyps are two relatively independent diseases or different stages of development of the same disease. DJ-1 protein expression differences are important for the pathogenesis and prognosis of chronic sinusitis and nasal polyps. There was no significant difference in the expression of DJ-1 protein in chronic sinusitis and nasal polyps. The reason may be that the syndrome differentiation of TCM is subjective or the type of patient's syndrome can change with the internal cause of external pathogens; on the other hand, it may be because of the small sample size, if the study of sample size is expanded in the future, different results may be obtained.
【學(xué)位授予單位】：云南中醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R276.1

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