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高原地区藏族人群慢性鼻窦炎炎症模式与微生物定植相关性研究
边片,巴罗,次仁德吉,米玛,杨芳丽,巴顿
0
(西藏日喀则市人民医院综合内科;西藏自治区人民医院耳鼻咽喉科)
摘要:
【摘要】 目的 探讨鼻窦炎黏膜炎症模式与微生物定植在高原藏族人群慢性鼻窦炎中的相关性。方法 收集2016年3月~2017年10月分别在日喀则市人民医院和西藏自治区人民医院就诊的耳鼻喉科藏族人群共105例:其中慢性鼻窦炎伴息肉患者40例(鼻息肉组),慢性鼻窦炎不伴息肉患者35例(慢性鼻窦炎组),鼻中隔偏曲30例(对照组)。采用免疫荧光检测组织免疫炎症介质,免疫组化观察组织形态学及培养微生物鉴定细菌谱。结果 慢性鼻窦炎不伴息肉(CRSsNP)表现为IFNγ和Ll17高于其他两组(P<005),IL8、IL1β高于对照组;组织中中性粒细胞和巨噬细胞浸润显著,微生物培养革兰氏阴性细菌培养率高于对照组(P<005)。慢性鼻窦炎伴息肉(CRSwNP)表现为IL5,ECP及总IgE显著增高(P<005),组织中以嗜酸性粒细胞及肥大细胞浸润为主要特征,革兰氏阳性细菌培养率显著高于其他两组(P<005)。结论 藏族人群慢性鼻窦炎中CRSsNP表现为Th1和Th17倾向的中性粒细胞炎症模式特征,可能与革兰氏阴性细菌优势定植相关;反之CRSwNP表现为Th2倾向以嗜酸性粒细胞炎症模式特征且与革兰氏阳性细菌定植相关。
关键词:  慢性鼻窦炎  微生物定植  炎症模式  藏族
DOI:
基金项目:
The association between bacterial colonization and inflammatory pattern in mucosa of chronic rhinosinusitis among high altitude dwelling Tibetans
BIAN Pian,BA Luo,CIREN Deji,MI ma,YANG Fangli,BA Dun
(Department of General Medicine, The Peoples Hospital of Rikaze Urban of Tibet Autonomous Region;Department of Otolaryngology, The Peoples Hospital of the Tibet Autonomous Region)
Abstract:
【Abstract】 Objective To study the upper airway mucosal inflammatory pattern, and evaluate associations between bacterial colonization in CRS of Tibetan patients. Methods Nasal sample tissue was obtained from 75 Tibetan CRS patients(40 CRSwNP, 35 CRSwNP)and 30 control subjects during endonasal sinus surgery or septoplasty. Samples were processed for assessment of proinflammatory cytokines and mediators by immunoassay. Prior to surgery nasal swabs were taken from each patient for microbiological evaluation. Results CRSsNPs were characterized by significantly high levels of IFNγ and IL17 Than other groups (P≤005), which slightly increased of IL8 and IL1β compared with that of the control. CRSwNPs were characterized by increased mediator promoting eosinophilic inflammation IL5, ECP and a predominance of eosinophils and mast cells (P≤005). Conclusion In highaltitude, the dwelling Tibetans of CRS presents a Th2 milieu with eosinophilic inflammatory reaction and associated with Gram- bacterial load in CRSwNPs, otherwise, Th1 and Th17 presents polarization with reaction of neutrophils inflammation and associated with Gram+ colonizing in CRSsNPs.
Key words:  Chronic rhinosinusitis  Bacterial colonization  Inflammatory pattern  Tibetan patients

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