|
Objective To summarize the clinical features of nasal polyps, observed nasal polyps, inflammatory cell infiltration characteristics and relationship to explore the classification and possible pathogenesis of nasal polyps. Retrospective analysis of the clinical data of 134 patients with nasal polyps, refer to the Chinese Medical Association in 2004 Lanzhou standard on the diagnosis of allergic rhinitis be divided into four kinds of clinical type: ① allergic performance-based nasal polyps: a history of continuous sneezing (more than three in a row at a time), flow of clear nasal discharge, nasal itching, nasal congestion as the main clinical manifestations and / or allergen allergen skin test was positive, intranasal endoscopic visible inferior turbinate and / or turbinate mucosa pale swelling of the nasal passages serous secretions; (2) infectious performance based nasal polyps: a history of repeated purulent nasal discharge, nasal congestion, headache as the main clinical manifestations, nasal endoscopic visible in the nasal passages and / or total nasal passages or maxillary sinus with purulent discharge; ③ The allergic coinfection performance of nasal polyps: the two performance at the same time; ④ simple nasal polyps as the main clinical manifestations: stuffy nose, no obvious clinical symptoms. Nasal polyps specimens of this 134 cases of application of special staining of HE staining and toluidine blue staining, each slice select five high power field (× 400), hand count of eosinophils, lymphocytes, plasma cells, neutral granulocytes and mast cell number and according to the number of different of different cell infiltration divided into four histologic types: ① eosinophil infiltration type: the number of eosinophils greater than 40/400 magnification, and lymphocyte number is less than the magnification 40/400; ② lymphocytic infiltration type: less than 40/400 times the number of eosinophils vision, lymphocyte count greater than 40/400 magnification; the ③ hybrid: the number of eosinophils 40/400 magnification, and lymphocyte count greater than 40/400 magnification; the ④ neutrophil infiltration type: neutrophil count greater than 40/400 magnification. Respectively, the average healing time of four clinical types and 4 histological types of nasal polyps and its tissue eosinophil number, the number of lymphocytes, mast cells, plasma cells, and neutrophil count were analyzed by ANOVA and two two compared to 134 cases of nasal polyps healing time correlation analysis, the number of eosinophils, mast cells, lymphocytes and plasma cells. Results in 134 patients with nasal polyps, allergic performance-based 36 (26.87%) cases, the combined performance of both the 19 (14.18%) cases of 58 (43.28%) cases of infectious performance-based pure 21 (15.67%) cases of nasal polyps. 4 clinical types mean eosinophil number, number of lymphocytes, mast cells, plasma cells, the average healing time were statistically significant (p <0.05), pairwise comparisons revealed: allergic merger infectious The nasal polyps performance cure the longest time (P <0.01). A variety of inflammatory cells in nasal polyps allergic performance-based nasal polyps inflammatory cells were statistically significant (P <0.05), which eosinophils; infectious performance-based number were statistically significant, which lymphocyte counts up. 134 cases of nasal polyps, eosinophils aggregation type 69 (51.49%) patients, 52 (38.81%) cases, mixed 10 (7.46%) cases of lymphocyte aggregation type; neutrophil accumulation type 3 (2.24% ) cases. For histologic types mean eosinophil number of lymphocytes, mast cells, neutrophil count, and plasma cells were statistically significant (P <0.01); the eosinophils gathered type of nasal polyps Organization in the number of mast cells, plasma cells, and neutrophil count below the the lymphocyte aggregation type (P <0.05). 134 cases of nasal polyps, the number of eosinophils and lymphocytes number was a negative correlation (r = -0.696, P <0.01), and mast cells was negatively correlated (r = -0.551, P <0.01), and pulp cell number was negatively correlated (r = -0.287, P <0.01); lymphocyte count and the number of mast cells was positively correlated (r = 0.601, P <0.01), the number of plasma cells was positively correlated (r = 0.269, P <0.01) ; the eosinophil number of the cure time was positively correlated (r = 0.175, P <0.05). Different conclusions clinical manifestations in patients with nasal polyps infiltrating inflammatory cell types differ, a variety of inflammatory cell infiltration and interaction may be an important part of the development of nasal polyps. Eosinophil infiltration allergic performance-based nasal polyps; the infectious performance-based nasal polyps lymphocytic infiltration. Eosinophil infiltration in nasal polyps more the longer patients cured. According to the characteristics of tissue infiltration classification may be the understanding of the pathogenesis of nasal polyps, nasal polyps, combined with clinical manifestations and guiding perioperative treatment of some significance. Objective: To investigate the correlation and its significance of Staphylococcus aureus superantigens with chronic sinusitis and nasal polyps. Methods: Using enzyme-linked immunosorbent assay (ELISA) detection of Staphylococcus aureus in chronic sinusitis with / without nasal polyps polyps / nose - sinus mucosa and nose history control group uncinate or turbinate mucosa super antigens A, B and C1, the positive rate and count corresponding tissue slices eosinophil number, used for statistical analysis. Results: ELISA method to detect nasal polyps or nose - sinus mucosa in Staphylococcus aureus superantigens SEA, SEB and SEC1 results showed: 32 cases out of 56 cases of nasal polyps antigen positive, the positive rate was 57.14%, which SEA positive seven cases, the SEB was positive in 24 cases, SEC1 positive in 4 patients, including 3 patients simultaneous detection of species 2 toxin, 2 cases of SEA and SEB, a case of SEC1 and a SEB; sinusitis group, one case superantigen positive rate 4.00%, the control group had no positive test results positive for SEB; Fisher exact comparison between the groups antigen positive rate highly significant difference (P <0.01), nasal polyps group were compared with sinusitis and control groups, the differences were statistically significant (P <0.05), while sinusitis was no significant difference between the group and the control group (P> 0.05). Among the three groups of eosinophils number difference was statistically significant (F = 187.946, P <0.01), pairwise comparisons revealed that: nasal polyps group with sinusitis group difference was statistically significant eosinophil numbers ( P <0.05), nasal polyps and control groups in eosinophil number difference was statistically significant (P <0.05) by t-test between the two groups of super-antigen positive and antigen negative eosinophils number of difference statistically significant (t = 0.983, P <0.05). Conclusion: staphylococcal superantigens in the activation of eosinophils play an important role, the development of a certain degree of correlation with the occurrence of chronic sinusitis and nasal polyps.
|