|本期目录/Table of Contents|

[1]於翔,程友,薛飞,等.正常成人鼻窦黏膜病理学特征观察[J].医学研究与战创伤救治(原医学研究生学报),2018,20(05):490-493.[doi:10.3969/j.issn.1672-271X.2018.05.009]
　YU Xiang,CHENG You,XUE Fei,et al.Comparison of morphological characteristics of anterior and posterior paranasal sinus mucosa in normal adults[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2018,20(05):490-493.[doi:10.3969/j.issn.1672-271X.2018.05.009]
点击复制

正常成人鼻窦黏膜病理学特征观察()
分享到62.8K

《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第20卷
期数:
2018年05期
页码:
490-493
栏目:
临床研究
出版日期:
2018-09-18

文章信息/Info

Title:
Comparison of morphological characteristics of anterior and posterior paranasal sinus mucosa in normal adults
作者:
於翔; 程友; 薛飞; 王志颐; 吴明海; 王天友
作者单位：210002南京，南京大学医学院附属金陵医院（南京军区南京总医院）耳鼻咽喉-头颈外科（於翔、程友、薛飞、王志颐、吴明海、王天友）
Author(s):
YU Xiang;  CHENG You;  XUE Fei;  WANG Zhi-yi;  WU Ming-hai;  WANG Tian-you
（Department of Otorhinolaryngology-Head and Neck Surgery, Jinling Hospital，Medical School of Nanjing University/Nanjing General Hospital of Nanjing Military Region, PLA, Nanjing 210002, Jiangsu, China）
关键词:
鼻窦; 黏膜; HE染色; 慢性鼻窦炎
Keywords:
paranasal sinus;  mucous membrane;  HE staining; chronic rinonasosinusitis
分类号:
R765.4
DOI:
10.3969/j.issn.1672-271X.2018.05.009
文献标志码:
A
摘要:
目的 通过研究前后组鼻窦黏膜的病理学特征，探讨不同鼻窦炎发病的组织形态学机制。方法 收集2016年1月至2017年12月南京军区南京总医院鼻内镜手术中留存切除的正常前后组鼻窦黏膜标本60份（上颌窦、前组筛窦、后组筛窦、蝶窦黏膜标本各15份），进行HE染色常规病理学观察，评估黏膜上皮层厚度、基底膜厚度和黏膜固有层内腺体面积分数（AF）。结果 前后组鼻窦黏膜的基本结构相同，均由一层假复层纤毛柱状上皮覆盖，上颌窦黏膜上皮层厚度[（14.58±0.94）μm]、基底膜厚度[（2.07±0.39）μm]、浆液腺面积分数AF[（24.78±5.87）%]和黏液腺AF[（18.50±1.41）%]均高于后组筛窦[（12.76±1.19）μm、（1.57±0.42）μm、（20.05±1.89）%、（10.39±0.68）%]、蝶窦[（12.92±1.21）μm、（1.71±0.47）μm、（19.74±1.92）%、（10.55±1.08）%]（P<0.05）；上颌窦仅上皮层厚度高于前组筛窦[（18.81±1.08）μm]（P<0.05）；前组筛窦上皮层厚度、基底膜厚度[（2.10±0.42）μm]和黏液腺AF[（18.81±1.08）%]均高于后组筛窦、蝶窦（P<0.05），浆液腺AF[（23.01±5.82）%]高于蝶窦（P<0.05）。结论 正常成人前后组鼻窦黏膜的组织病理学特征存在差异，这可能与不同鼻窦的解剖因素、刺激因子及黏膜组织反应等有关，所以发生在前后组鼻窦的鼻窦炎可能存在不同的发病机理。
Abstract:
Objective To investigate the histomorphological mechanism of different sinusitis, the pathological features of anterior and posterior paranasal sinus mucosa were studied.Methods Sixty normal anterior and posterior sinus mucosa specimens [15 mucosal specimens of maxillary sinus（MS），anterior ethmoid sinus（AES），posterior ethmoid sinus（PES） and sphenoid sinus（SS）] were recruited in Nanjing General Hospital of PLA from January 2016 to December 2017. The routine pathological features were observed via the HE staining assay and subsequently subjected to the evaluation of the thickness of mucosal epithelium, basal membrane thickness and glandular area fraction (AF) in the mucosa.Results The basic structures of the anterior and posterior paranasal sinus mucosa are shown the same structure and covered by a pseudostratified cilia columnar epithelium. Maxillary sinus mucosal epithelium thickness [(14.58±0.94) μm], basal membrane thickness [(2.07±0.39) μm], serous glandular area fraction AF [(24.78±5.87)%]and mucinous AF[(18.50±1.41)%] were higher than those of the posterior ethmoid sinus [(12.76± 1.19) μm, (1.57±0.42) μm, (20.05±1.89)%, (10.39±0.68)%], sphenoid sinus [(12.92±1.21) μm, (1.71±0.47) μm, (19.74±1.92)%, (10.55±1.08)% (P<0.05. The thickness of the maxillary sinus epithelium was higher than that of the anterior ethmoid sinus [(18.81±1.08) μm] (P<0.05). The thickness of the anterior ethmoid sinus epithelium, basal membrane thickness [(2.10±0.42) μm] and the mucinous gland AF [(18.81±1.08)%] were higher than those of the posterior ethmoid sinus, sphenoid sinus (P<0.05). The serous glandular AF [(23.01±5.82)%] was higher than sphenoid sinus (P<0.05).Conclusion The histopathological characteristics of anterior and posterior paranasal sinus mucosa in normal adult are different, which may be owing to anatomic factors, stimulating factors and mucosal tissue responses. Therefore, there may be different pathogenesis in anterior and posterior paranasal sinusitis.

参考文献/References:

[1]王德辉,王德云,于华鹏，等.欧洲鼻腔鼻窦解剖术语意见书(一)[J].中国眼耳鼻喉科杂志,2017,17(2):110-112.
[2]中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组.中华耳鼻咽喉头颈外科学会鼻科学组.慢性鼻-鼻窦炎诊断和治疗指南（2012年，昆明）[J]. 中华耳鼻咽喉头颈外科杂志，2013,48（2）：92-94.
[3]Rudmik L, Soler ZM. Medical Therapies for Adult Chronic Sinusitis: A Systematic Review[J].JAMA, 2015, 314(9):926.
[4]Rix I, Hkansson K, Larsen CG, et al.Management of chronic rhinosinusitis with nasal polyps and coexisting asthma: A systematic review[J]. Am J Rhinol Allergy, 2015, 29(3):193-201.
[5]Adnane C, Adouly T, Zouak A, et al.Quality of life outcomes after functional endoscopic sinus surgery for nasal polyposis[J]. Am J Otolaryngol, 2015, 36(1):47-51.
[6]钱旭东, 周锦川, 邵先安,等. IL-32在变应性鼻炎及慢性鼻-鼻窦炎鼻黏膜组织中的表达[J]. 东南国防医药, 2018,20(2): 189-191.
[7]Tan BK, Peters AT, Schleimer RP,et al. Pathogenic and protective roles of B cells and antibodies in patients with chronic rhinosinusitis[J]. J Allergy Clin Immunol，2018,141(5):1553-1560.
[8]Kim DK, Wi YC, Shin SJ,et al.Bacterial Ball as an Unusual Finding in Patients With Chronic Rhinosinusitis[J]. Clin Exp Otorhinolaryngol,2018,11(1)：40-45.
[9]王天友,王志颐,江满杰,等.鼻腔鼻窦疾病治疗后中学生血液红细胞和记忆商的变化[J].医学研究生学报,2011,24(10):42-44.
[10]Jain R, Waldvogel-Thurlow S, Darveau R, et al.Differences in the paranasal sinuses between germ-free and pathogen-free mice[J]. Int Forum Allergy Rhinol, 2016, 6(6):631-637.
[11]Sorensen HB, Larsen PL, Tos M.The influence of air current on goblet cell density in the mucosa of the normal unci-nate process in the nasal cavity[J]. Rhinology，2006, 44(3): 188-192.
[12]Tieu DD, Kern RC，Schleimer RP. Alterations in epithelial barrier function and host defense responses in chronic rhinosinusitis[J]. J Allergy Clin Immunol, 2009, 124(1):37-42.
[13]Bradding P, Feather IH, Wilson S, et al.Immunolocalization of cytokines in the nasal mucosa of normal and perennial rhinitic subjects. The mast cell as a source of IL-4, IL-5, and IL-6 in human allergic mucosal inflammation[J]. J Immunol，1993，151(7):3853-3865.
[14]Gencer Z K,zkr �瘙 塂 M, Okur A, et al. The effect of nasal septal deviation on maxillary sinus volumes and development of maxillary sinusitis[J]. Eur Arch Otorhinolaryngol, 2013, 270(12):3069-3073.
[15]Berger G, Balum-Azim M, Ophir D.The normal inferior turbinate: histomorphometric analysis and clinical implications[J]. Laryngoscope，2003，113(7):1192-1198.
[16]Boon M, Wallmeier J, Ma L, et al. MCIDAS mutations result in a mucociliary clearance disorder with reduced generation of multiple motile cilia[J]. Nat Commun, 2014, 22(5):4418.
[17]Fordham MT, Mulligan JK, Casey SE, et al.Reactive oxygen species in chronic rhinosinusitis and secondhand smoke exposure[J]. Otolaryngol Head Neck Surg, 2013, 149(4):633-638.
[18]刘小凯,魏永杰,张保荣,等.高浓度大气PM2.5混悬液对大鼠鼻黏膜及上颌窦黏膜影响研究[J].口腔颌面修复学杂志,2017,18(3):168-172.

相似文献/References:

备注/Memo

备注/Memo:
基金项目：中国博士后科学基金（2017M613438）；南京军区南京总医院院管课题（2017001）
更新日期/Last Update: 2018-09-20