宋　锴， 龚正鹏

(贵州医科大学附院 耳鼻喉科， 贵州 贵阳　550004)



糖皮质激素对鼻息肉组织中巨噬细胞移动抑制因子水平的影响

宋锴， 龚正鹏

(贵州医科大学附院 耳鼻喉科， 贵州 贵阳550004)

目的： 探讨糖皮质激素对鼻息肉组织巨噬细胞移动抑制因子(MIF)表达的影响。方法： 慢性鼻窦炎伴鼻息肉患者27例，未用激素治疗前取息肉组织为A组，经糖皮质激素治疗3～5 d后再取息肉组织为B组，另取行鼻中隔矫正术患者的中隔正常鼻黏膜作为对照组(C组，20例)，采用免疫组织化学法观察MIF在鼻黏膜的分布及MIF阳性率。结果： MIF阳性细胞分布于上皮层、固有层以及腺上皮层，A、B组MIF阳性率分别为85.18%和81.48%，A组略高于B组，但两组比较差异无统计学意义(P>0.05)；C组MIF阳性率为25%，低于 A、B组，差异具有统计学意义(P<0.05)。结论： MIF在鼻息肉组织中呈高表达，这可能与鼻息肉的发生发展有关；短期局部运用糖皮质激素对MIF水平影响不明显。

鼻息肉； 巨噬细胞游走抑制因子； 糖皮质激素类； 免疫组织化学

[Abstract]Objective: To investigate the effect of glucocorticoid on the expression of macrophage migration inhibitory factor (MIF) in nasal polyps. Methods: 27 cases of patients with nasal polyps were collected. Before hormone therapy the nasal polyps tissue were taken out from 27 cases as a group A(27 cases) while 3 to 5 days after glucocorticoid treatment the nasal polyp tissue were taken out as group B(27 cases). Normal septum nasal mucosa of 20 patients undergoing correction of nasal septum were taken out as group C(20 cases). The distribution of MIF in nasal mucosa and the positive rates of MIF were observed by immunohistochemical method. Results: Immunohistochemical staining showed that MIF positive cells were distributed in the epithelium, lamina propria and glandular epithelium. The rates of positive cell of MIF in group A and group B were 85.18% and 81.48%, respectively. The rates of positive cell of MIF in group A were slightly higher than group B, but the differences were statistically insignificant(P>0.05). The positive rates of MIF in group C was 25%, lower than those of both group A and group B, and the differences were statistically significant(P<0.05). Conclusions: MIF is highly expressed in nasal polyps, which may be related to the occurrence and development of nasal polyps. In short term, local use of glucocorticoids on the level of MIF is not obvious.

[Key words]nosal polyps; macrophage migration inhibitory factor; glucocorticoid; immunohistochemistry

鼻息肉是发生在鼻腔及鼻窦黏膜的慢性炎症，主要病理学特征是以嗜酸性粒细胞为主的多种炎性细胞浸润、组织水肿、上皮细胞增生、血管扩张及腺体增生。巨噬细胞移动抑制因子(MIF)是调节免疫功能的关键细胞因子，在许多免疫系统疾病及炎症性疾病如哮喘、感染性休克、风湿性关节炎、肺炎、肺癌及胰腺炎等疾病时表达都增高[1]。现在已经证实多种细胞因子参与了鼻息肉发生和发展，并可以为糖皮质激素所调节，但与其它细胞因子不同,糖皮质激素可双向调节MIF的表达。本实验对鼻息肉中MIF的表达及糖皮质激素对MIF表达的影响进行研究，为探讨鼻息肉的发病机理及糖皮质激素治疗机制提供一定的理论参考。