中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2014年
12期
1006-1012
,共7页
卫红齐%朱政文%曹忠胜%刘志勇%邬晓帆%袁辉
衛紅齊%硃政文%曹忠勝%劉誌勇%鄔曉帆%袁輝
위홍제%주정문%조충성%류지용%오효범%원휘
葡萄球菌,金黄色%肠毒素类%鼻窦%鼻黏膜%显微镜检查
葡萄毬菌,金黃色%腸毒素類%鼻竇%鼻黏膜%顯微鏡檢查
포도구균,금황색%장독소류%비두%비점막%현미경검사
Staphylococcus aureus%Enterotoxins%Paranasal sinuses%Nasal mucosa%Microscopy
目的 探讨不同浓度金黄色葡萄球菌肠毒素A(staphylococcal enterotoxin A,SEA)对兔上颌窦黏膜纤毛上皮超微结构及炎性反应的影响.方法 48只兔完全随机分成低剂量SEA组(0.3ng/ml)和高剂量SEA组(30 ng/ml),每组24只.造模后每天向低剂量SEA组和高剂量SEA组左上颌窦腔分别注入SEA 2 ml,右上颌窦腔每天注入2ml生理盐水作为对照侧.造模后3、7、14、28d每组任意选6只免行鼻窦CT检查,后处死并获取双侧上颌窦黏膜标本行组织形态学观察.用苏木精-伊红(HE)和甲苯胺蓝染色在光镜下观察黏膜炎性改变情况.用扫描电镜及透射电镜观察黏膜上皮超微结构改变.以SPSS13.0软件进行统计学分析.结果 在14、28d,高剂量SEA组鼻窦CT检查示左上颌窦腔浑浊;光镜观察分析示左上颌窦黏膜上皮溃疡百分比分别为(22.73 ±5.72)％、(30.79 ±4.30)％,上皮下层厚度分别为(113.34±14.81) μm、(120.86±12.35) μm,与低剂量SEA组的(5.12±1.98)％、(5.38±1.64)％、(71.08±10.39) μm、(81.63 ±9.32) μm比较,差异均有统计学意义(q值分别为10.079、19.132、8.090、8.782,P值均＜0.01),与对照组的(4.08±1.29)％、(4.81±1.62)％、(37.45±7.67) μm、(38.79±7.68) μm比较,差异亦均有统计学意义(q值分别为11.016、19.592、15.759、19.541,P值均＜0.01);电镜观察示纤毛大片缺失,可见复合纤毛、胞质突起、内质网扩张及线粒体肿胀.而低剂量SEA组在14、28d,CT检查左上颌窦腔透明,嗜酸粒细胞计数多于高剂量SEA组和对照组(q14值分别为5.871、6.766,q28值分别为7.572、8.970,P值均＜0.05),但上皮溃疡百分比与对照组比较差异无统计学意义(q值分别为1.512、0.859,P值均＞0.05);电镜下见纤毛紊乱、相互粘连,无明显缺失,未见复合纤毛及胞质突起,内质网及线粒体结构未见明显改变.结论 SEA在低浓度时引起鼻窦黏膜变应性炎性反应,而对纤毛上皮结构无显著破坏作用;SEA在高浓度时可导致纤毛上皮细胞内线粒体和内质网结构发生改变,并引起纤毛丢失及上皮脱落,可能是诱发急性鼻-鼻窦炎的主要原因之一.
目的 探討不同濃度金黃色葡萄毬菌腸毒素A(staphylococcal enterotoxin A,SEA)對兔上頜竇黏膜纖毛上皮超微結構及炎性反應的影響.方法 48隻兔完全隨機分成低劑量SEA組(0.3ng/ml)和高劑量SEA組(30 ng/ml),每組24隻.造模後每天嚮低劑量SEA組和高劑量SEA組左上頜竇腔分彆註入SEA 2 ml,右上頜竇腔每天註入2ml生理鹽水作為對照側.造模後3、7、14、28d每組任意選6隻免行鼻竇CT檢查,後處死併穫取雙側上頜竇黏膜標本行組織形態學觀察.用囌木精-伊紅(HE)和甲苯胺藍染色在光鏡下觀察黏膜炎性改變情況.用掃描電鏡及透射電鏡觀察黏膜上皮超微結構改變.以SPSS13.0軟件進行統計學分析.結果 在14、28d,高劑量SEA組鼻竇CT檢查示左上頜竇腔渾濁;光鏡觀察分析示左上頜竇黏膜上皮潰瘍百分比分彆為(22.73 ±5.72)％、(30.79 ±4.30)％,上皮下層厚度分彆為(113.34±14.81) μm、(120.86±12.35) μm,與低劑量SEA組的(5.12±1.98)％、(5.38±1.64)％、(71.08±10.39) μm、(81.63 ±9.32) μm比較,差異均有統計學意義(q值分彆為10.079、19.132、8.090、8.782,P值均＜0.01),與對照組的(4.08±1.29)％、(4.81±1.62)％、(37.45±7.67) μm、(38.79±7.68) μm比較,差異亦均有統計學意義(q值分彆為11.016、19.592、15.759、19.541,P值均＜0.01);電鏡觀察示纖毛大片缺失,可見複閤纖毛、胞質突起、內質網擴張及線粒體腫脹.而低劑量SEA組在14、28d,CT檢查左上頜竇腔透明,嗜痠粒細胞計數多于高劑量SEA組和對照組(q14值分彆為5.871、6.766,q28值分彆為7.572、8.970,P值均＜0.05),但上皮潰瘍百分比與對照組比較差異無統計學意義(q值分彆為1.512、0.859,P值均＞0.05);電鏡下見纖毛紊亂、相互粘連,無明顯缺失,未見複閤纖毛及胞質突起,內質網及線粒體結構未見明顯改變.結論 SEA在低濃度時引起鼻竇黏膜變應性炎性反應,而對纖毛上皮結構無顯著破壞作用;SEA在高濃度時可導緻纖毛上皮細胞內線粒體和內質網結構髮生改變,併引起纖毛丟失及上皮脫落,可能是誘髮急性鼻-鼻竇炎的主要原因之一.
목적 탐토불동농도금황색포도구균장독소A(staphylococcal enterotoxin A,SEA)대토상합두점막섬모상피초미결구급염성반응적영향.방법 48지토완전수궤분성저제량SEA조(0.3ng/ml)화고제량SEA조(30 ng/ml),매조24지.조모후매천향저제량SEA조화고제량SEA조좌상합두강분별주입SEA 2 ml,우상합두강매천주입2ml생리염수작위대조측.조모후3、7、14、28d매조임의선6지면행비두CT검사,후처사병획취쌍측상합두점막표본행조직형태학관찰.용소목정-이홍(HE)화갑분알람염색재광경하관찰점막염성개변정황.용소묘전경급투사전경관찰점막상피초미결구개변.이SPSS13.0연건진행통계학분석.결과 재14、28d,고제량SEA조비두CT검사시좌상합두강혼탁;광경관찰분석시좌상합두점막상피궤양백분비분별위(22.73 ±5.72)％、(30.79 ±4.30)％,상피하층후도분별위(113.34±14.81) μm、(120.86±12.35) μm,여저제량SEA조적(5.12±1.98)％、(5.38±1.64)％、(71.08±10.39) μm、(81.63 ±9.32) μm비교,차이균유통계학의의(q치분별위10.079、19.132、8.090、8.782,P치균＜0.01),여대조조적(4.08±1.29)％、(4.81±1.62)％、(37.45±7.67) μm、(38.79±7.68) μm비교,차이역균유통계학의의(q치분별위11.016、19.592、15.759、19.541,P치균＜0.01);전경관찰시섬모대편결실,가견복합섬모、포질돌기、내질망확장급선립체종창.이저제량SEA조재14、28d,CT검사좌상합두강투명,기산립세포계수다우고제량SEA조화대조조(q14치분별위5.871、6.766,q28치분별위7.572、8.970,P치균＜0.05),단상피궤양백분비여대조조비교차이무통계학의의(q치분별위1.512、0.859,P치균＞0.05);전경하견섬모문란、상호점련,무명현결실,미견복합섬모급포질돌기,내질망급선립체결구미견명현개변.결론 SEA재저농도시인기비두점막변응성염성반응,이대섬모상피결구무현저파배작용;SEA재고농도시가도치섬모상피세포내선립체화내질망결구발생개변,병인기섬모주실급상피탈락,가능시유발급성비-비두염적주요원인지일.
Objective To investigate the ultrastructure of ciliated epithelia and inflammatory changes upon repeated exposure to staphylococcal enterotoxin A (SEA) of different concentrations in the maxillary sinus mucosa of rabbits.Methods The rabbits were randomly divided into 2 groups (24 rabbits per group):low-dose SEA group and high-dose SEA group.The low-dose SEA group and high-dose SEA group received daily injections of 0.6 ng of SEA (2 ml) and 60 ng of SEA (2 ml) into the left maxillary sinus of rabbits for 28 days,respectively.Concurrent treatment of the right maxillary sinus with normal saline was used as control.Six rabbits chosen randomly in two groups were examined by computed tomography (CT) scans and then sacrificed to obtain thc sinus mucosa from the two-side of maxillary sinuses for histological assessment on days 3,7,14 and 28.To characterize the inflammatory changes of the sinus mucosa examined using light microscope,hematoxylin and eosin (HE) and toluidine blue staining was performed.Scanning and transmission electron microscopy were performed to observe ultrastructure of ciliated epithelia in the maxillary sinus mucosa.SPSS 13.0 software was used to analyze the data.Results On days 14 and 28,CT images showed opacification of the left maxillary sinus in the high-dose SEA group.The percentage of epithelial disruption was (22.73 ± 5.72) ％ and (30.79 ± 4.30)％ in the high-dose SEA group respectively,and were significantly greater than those in the low-dose SEA group (5.12％ ± 1.98％ and 5.38％ ± 1.64％,q value was 10.079 and 19.132) and control group (4.08％ ± 1.29％ and 4.81％ ± 1.62％,q value was 11.016 and 19.592,respectively,all P ＜ 0.01).The subepithelial thickness in the high-dose SEA group was (113.34 ± 14.81) μm and (120.86 ± 12.35) μm respectively,and were significantly different from those of the low-dose SEA group[(71.08 ± 10.39) μm and (81.63 ±9.32) μm,q value was 8.090 and 8.782] and control group [(37.45 ± 7.67) μm and (38.79 ± 7.68) μm,q value was 15.759 and 19.541,all P ＜0.01].Viewed under the electron microscope,loss of cilia was observed,a few compound cilia and cytoplasmic protrusion were found,an obvious stretching of the endoplasmic reticulum and an obvious turgescence of the mitochondria was also observed.However,in the low-dose SEA group on days 14 and 28,CT scan of the left maxillary sinus showed transparency; light microscopy observations of the maxillary sinus mucosa showed the number of eosinophils was markedly increased as compared with the high-dose SEA and control groups,the differences were significant (q value was 5.871 and 6.766 on day 14,and q value was 7.572 and 8.970 on day 28,respectively,all P ＜ 0.05).But no significant differences were observed in epithelial disruption between the low-dose SEA and the control groups on days 14 and 28 (q value was 1.512 and 0.859 respectively,all P ＞0.05) ; inordinate array and adhesion of cilia was observed,but cilia loss,compound cilia,cytoplasmic protrusions,mitochondrial swelling and endoplasmic reticulum stretching were not found.Conclusions SEA may induce allergic inflammation of the sinus mucosa without damaging the structure of ciliated epithelia at low concentration.Whereas SEA impairs the structure of mitochondria and endoplasmic reticulum in ciliated epithelial cells at high concentration,and results in cilia loss and epithelial disruption,which may be one of the main reasons to induce acute sinusitis.
