CAJ | 학술논문

目的通过电子显微镜观察慢性鼻-鼻窦炎患者手术黏膜样本是否存在细菌生物膜及其形态学特征,分析细菌生物膜形成与临床因素的相关性.方法实验组获取69例慢性鼻-鼻窦炎患者手术中筛窦黏膜样本,对照组获取15例鼻中隔偏曲患者、10例鼻骨骨折患者钩突黏膜样本,所有样本均行扫描电子显微镜检查.以CRS患者常见的临床表现为调查条目,借鉴鼻窦炎专用量表—鼻腔鼻窦结局测试20的等级描述形式,对患者进行术前临床因素评估.应用SPSS 10.0软件进行统计学分析,细菌生物膜形成与临床因素的相关性分析采用卡方检验.结果实验组样本发现细菌生物膜的病例49例,阳性率为71.0％(49/69).所有实验组样本均观察到黏膜纤毛不同程度的损伤.对照组样本未发现细菌生物膜,可以观察到黏膜纤毛较浓密,排列整齐.卡方检验结果表明细菌生物膜阴性组与阳性组在性别、疾病分期、病程,以及鼻塞、流涕、鼻涕臭味、头痛、涕血、嗅觉减退等临床症状方面差异无统计学意义.结论慢性鼻-鼻窦炎患者黏膜可以观察到不同生命周期的细菌生物膜及黏膜纤毛损伤,细菌生物膜参与慢性鼻-鼻窦炎的发病过程.细菌生物膜形成与各临床症状无相关性.
목적 통과전자현미경관찰만성비-비두염환자수술점막양본시부존재세균생물막급기형태학특정,분석세균생물막형성여림상인소적상관성.방법 실험조획취69례만성비-비두염환자수술중사두점막양본,대조조획취15례비중격편곡환자、10례비골골절환자구돌점막양본,소유양본균행소묘전자현미경검사.이CRS환자상견적림상표현위조사조목,차감비두염전용량표—비강비두결국측시20적등급묘술형식,대환자진행술전림상인소평고.응용SPSS 10.0연건진행통계학분석,세균생물막형성여림상인소적상관성분석채용잡방검험.결과 실험조양본발현세균생물막적병례49례,양성솔위71.0％(49/69).소유실험조양본균관찰도점막섬모불동정도적손상.대조조양본미발현세균생물막,가이관찰도점막섬모교농밀,배렬정제.잡방검험결과표명세균생물막음성조여양성조재성별、질병분기、병정,이급비새、류체、비체취미、두통、체혈、후각감퇴등림상증상방면차이무통계학의의.결론 만성비-비두염환자점막가이관찰도불동생명주기적세균생물막급점막섬모손상,세균생물막삼여만성비-비두염적발병과정.세균생물막형성여각림상증상무상관성.
Objective To observe the bacterial biofilm in patients with chronic rhinosinusitis (CRS), and to investigate the possible relationship between biofilm and clinical factors. Methods Sixtynine patients with CRS ( study group), 15 patients with nasal septum deviation and 10 patients with nasal bone fracture (control group) were enrolled in the study. Mucosa specimens of uncinate process or ethmoid near the ostium of the maxillary sinus were obtained during endoscopic sinus surgery. The specimens were subjected to scanning electron microscopy. All patients were evaluated by questionnaire of chnical factors based on sino-nasal outcome test-20. SPSS 10. 0 was used for statistical analysis, and the relationship between bacterial biofilm and clinical factors was evaluated by Chi-square test. Results Bacterial biofilms were found in 49 patients ( 71.0％ ) with CRS. A marked destruction of the epithelium and cilia was observed in all samples of study group. No bacterial biofilm was found in the control group, and scanning electron microscopy showed normal epithelium and cilia in those specimens. Chi-square test showed that bacterial biofilm was not associated with clinical factors (gender, staging, course, nasal obstruction, phlegm, nasal discharge with stinking smell, headache, bloody nasal discharge and olfactory degeneration) in CRS. Conclusions Bacterial biofilms and destruction of the epithelium and cilia can be obscrved in CRS patients, which may be involved in the pathogenesis of CRS, but the formation of bacterial biofilm is not correlated with the clinical factors in CRS.