【摘要】 目的观察慢性鼻-鼻窦炎(CRS)病人鼻腔/鼻窦黏膜表面细菌生物膜(BBF)的形态特点及其分布,并探讨BBF与CRS的临床相关性。方法选取67例行鼻内镜手术治疗的病人,包括CRS伴鼻息肉(CRSwNP)组27例,CRS不伴鼻息肉(CRSsNP)组25例,对照组为15例无鼻部症状接受经鼻手术的视神经减压、骨瘤或脑脊液鼻漏的病人。详细记录研究对象一般情况,包括症状评分、鼻窦内镜评分及影像学评分等。所有病人均于术中取中鼻甲、钩突及筛窦黏膜标本,并用激光扫描共聚焦显微镜观察BBF的形态特点,分析各组间的差异性及不同解剖部位BBF表达的差异性,并对BBF的存在状况与部分临床指标的关系进行分析。结果不同组BBF表达的阳性率比较,差异均有显著性(χ~2=3.957～25.667,P<0.05)。中鼻甲BBF表达的阳性率与筛窦比较,差异具有显著性(χ~2=9.905,P<0.05)。BBF表达阳性的CRS病人总的VAS评分和鼻窦内镜评分与阴性病人相比差异具有显著性(t=5.71、t′=6.62,P<0.05)。两组既往鼻窦手术史、病史长短及鼻窦影像评分,差异无显著性(P>0.05)。结论CRS病人鼻腔/鼻窦黏膜表面存在BBF,BBF的表达情况与CRS的严重程度相关。更多还原

【Abstract】 Objective To investigate the morphological characteristics and distribution of bacterial biofilms(BBF)on the surface of nasal cavity/paranasal sinus mucosa in patients with chronic rhinitis-sinusitis(CRS),as well as the clinical association between BBF and CRS. Methods A total of 67 patients who underwent endoscopic sinus surgery were enrolled,among whom 27 had CRS with nasal polyps(CRSwNP group)and 25 had no nasal polyps(CRSsNP group);15 patients who had no nasal symptoms and underwent transnasal surgery for optic nerve decompression,osteoma,or cerebrospinal fluid rhinorrhea were enrolled as control group.Related clinical information was recorded,including symptom score,endoscopic score of the paranasal sinus,and imaging score.The specimens of the mucosa of the middle turbinate,the uncinate process,and the ethmoid sinus were collected during surgery,and a confocal laser scanning microscope was used to observe the morphological characteristics of BBF,which were then compared between groups.The expression of BBF at different anatomic sites was also compared between groups.The association of the presence of BBF with some clinical indices was analyzed. Results There was a significant difference in the positive rate of BBF between groups(χ~2=3.957-25.667,P<0.05).The expression of BBF in the middle turbinate differed significantly from that in the ethmoid sinus(χ~2=9.905,P<0.05).There were significant differences in total Visual Analogue Scale score and endoscopic score of the paranasal sinus between the CRS patients with positive BBF expression and those without BBF expression(t=5.71,t′=6.62,P<0.05).There were no significant differences between the two groups in history of paranasal sinus surgery,duration of disease,and imaging score of paranasal sinus(P>0.05). Conclusion BBF is often observed on the surface of nasal cavity/paranasal sinus mucosa in patients with CRS,and the expression of BBF is associated with the severity of CRS.更多还原