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目的:采用免疫组织化学实验并扩大标本量与临床疗效相结合观察垂体腺苷酸环化酶激活肽(PACAP)蛋白在慢性鼻-鼻窦炎、鼻息肉、难治性慢性鼻-鼻窦炎及正常鼻黏膜组织中的表达情况,了解PACAP蛋白与慢性鼻-鼻窦炎和鼻息肉发病、转归及预后的关系。方法:采用免疫组织化学SP法分别检测53例鼻息肉、70例慢性鼻-鼻窦炎、28例难治性慢性鼻-鼻窦炎病变组织和20例正常鼻黏膜组织石蜡标本的PACAP蛋白表达情况。结果:1PACAP蛋白表达于鼻黏膜上皮、腺上皮和杯状细胞的胞质和胞核中;2鼻息肉、慢性鼻-鼻窦炎、难治性慢性鼻-鼻窦炎和正常鼻黏膜组织之间PACAP蛋白阳性强度构成比差异有统计学意义(χ2=140.902,P<0.01)。鼻息肉组织的阳性强度以“+”为主,慢性鼻-鼻窦炎组织的阳性强度以“+++”为主,难治性慢性鼻-鼻窦炎组织的阳性强度以“-~+”为主,正常鼻黏膜组织的阳性强度以“++”为主。结论:PACAP蛋白是机体保护性蛋白,当鼻黏膜受病原体侵袭或理化因素刺激引起炎症反应时,鼻黏膜上皮、腺上皮和杯状细胞,尤其是腺体反应性增生明显,它们产生和分泌PACAP蛋白等抗炎物质增多从而起到炎症防御作用。当PACAP减少后,对鼻黏膜的抗炎及免疫调节作用下降,因此炎症易迁延不愈或致息肉复发。
OBJECTIVE: To observe the effect of pituitary adenylate cyclase activating protein (PACAP) on chronic rhinosinusitis, nasal polyps, refractory chronic rhinosinusitis and normal by immunohistochemistry and to expand the specimen size and clinical efficacy. Nasal mucosa, to understand the relationship between PACAP protein and the incidence, prognosis and prognosis of chronic rhinosinusitis and nasal polyps. Methods: The expressions of PACAP protein in 53 cases of nasal polyps, 70 cases of chronic rhinosinusitis, 28 cases of refractory chronic rhinosinusitis and 20 cases of normal nasal mucosa were detected by immunohistochemical SP method. Results: 1PACAP protein was expressed in the cytoplasm and nucleus of nasal epithelium, glandular epithelium and goblet cells; 2 PACAP between nasal polyps, chronic rhinosinusitis, refractory chronic rhinosinusitis and normal nasal mucosa The positive rate of protein positivity was significantly different (χ2 = 140.902, P <0.01). The positive intensity of nasal polyps was predominantly “+”, and the positive intensity of chronic rhinosinusitis was mainly “+++”. The positive intensity of refractory chronic rhinosinusitis was “ - ~ + ”, the positive intensity of normal nasal mucosa is mainly based on “ ++ ”. CONCLUSIONS: PACAP protein is a protective protein of the body. When the nasal mucosa is affected by pathogens or stimulated by physical and chemical factors to cause inflammatory reaction, the nasal mucosa epithelium, glandular epithelium and goblet cells, especially the glandular cells, proliferate remarkably. They produce and secrete PACAP Increased anti-inflammatory substances such as proteins play a role in inflammation and defensive. When PACAP is reduced, the anti-inflammatory and immunomodulatory effects on the nasal mucosa are diminished, so inflammation tends to delay unhealed or polyp recurrence.