Expression of COX-2 and transcription factor CCAAT enhancer binding proteinβin refractory sinusitis with nasal polyps and its significance

Objective To study the expression and significance of COX-2 and C/EBP-βin refractory sinusitis with nasal polyps,and to explore the relationship between them and the recurrence of sinusitis with nasal polyps.Methods The protein expression of COX-2 and C/EBP-βin 20 cases of refractory sinusitis with nasal polyps,20 cases of sinusitis with nasal polyps and 20 cases of normal nasal mucosa were detected by western blot,and the relationship between the two was compared.Results The expression levels of COX-2 and C/EBP-βin refractory sinusitis with nasal polyps were significantly different from those in refractory sinusitis with nasal polyps(P<0.05);The expression levels of COX-2 and C/EBP-βin sinusitis tissues with nasal polyps were significantly different from those in normal nasal mucosa tissues(P<0.05);The expression levels of COX-2 and C/EBP-βin each group were significantly correlated(P<0.05).Conclusions The high expression of COX-2 and C/EBP-βmay be closely related to postoperative recurrence of sinusitis patients with nasal polyps.Both may be used as objective indicators to judge the postoperative follow-up and recurrence tendency of patients with sinusitis with nasal polyps..     

上颌窦鳞状细胞癌60例临床分析

Objective To study the clinical characters, treatment modalities and prognosis of patients with maxillary squamous cell carcinoma. Methods The clinical data of 60 patients with maxillary squamous cell carcinoma treatment between January 1994 and December 2004 were analyzed retrospectively.The patients were treated with three therapy modalities including radiotherapy alone(22 cases) ,radiotheraphy and surgery( R +S, 29 cases)and concurrent chemo-radio-therapy adjuvant surgery (CCR + S, 9 cases).Results The five year survival rate were 18.2%, 51.7% and 33.3% for patients in the radiotherapy alone group, the R + S group and the CCR + S group, respectively. Patients receiving R + S combined modality therapy had a significantly higher five year survival rate than the patients who were treated radiotherapy alone ( λ2 = 15.62, P <0.01 ). The five year survival rate(51.7% ) of patients in R + S group was significantly higher than that (33. 3% ) of patients in CCR + S group ( λ2 = 4. 28, P < 0.05 ), and also higher than that ( 18. 2% ) of patients in radiotherapy group( λ2 =9.49 ,P <0. 01 ). Conclusions The combined therapy of radiation and surgery was a good choice of treatment for the patients with maxillary sinus squamous cell carcinoma. The role of concurrent chemo-radiotherapy adjuvant surgery in the treatment of maxillary sinus squamous cell carcinoma needs further to research.     

上颌窦鳞状细胞癌60例临床分析

Objective To study the clinical characters, treatment modalities and prognosis of patients with maxillary squamous cell carcinoma. Methods The clinical data of 60 patients with maxillary squamous cell carcinoma treatment between January 1994 and December 2004 were analyzed retrospectively.The patients were treated with three therapy modalities including radiotherapy alone(22 cases) ,radiotheraphy and surgery( R +S, 29 cases)and concurrent chemo-radio-therapy adjuvant surgery (CCR + S, 9 cases).Results The five year survival rate were 18.2%, 51.7% and 33.3% for patients in the radiotherapy alone group, the R + S group and the CCR + S group, respectively. Patients receiving R + S combined modality therapy had a significantly higher five year survival rate than the patients who were treated radiotherapy alone ( λ2 = 15.62, P <0.01 ). The five year survival rate(51.7% ) of patients in R + S group was significantly higher than that (33. 3% ) of patients in CCR + S group ( λ2 = 4. 28, P < 0.05 ), and also higher than that ( 18. 2% ) of patients in radiotherapy group( λ2 =9.49 ,P <0. 01 ). Conclusions The combined therapy of radiation and surgery was a good choice of treatment for the patients with maxillary sinus squamous cell carcinoma. The role of concurrent chemo-radiotherapy adjuvant surgery in the treatment of maxillary sinus squamous cell carcinoma needs further to research.     

鼻腔筛窦鳞状细胞癌146例治疗分析

Objective To evaluate the treatment outcome of different therapeutic modalities for squamous cell cacinoma of the nose and ethmoid sinus and prognostic factors. Methods One hundred and forty-six cases of squamous cell carcinoma of the nose and ethmoid sinus treated from 1990 to 2007 were reviewed. Of the 146 cases,28 were at stage Ⅰ or Ⅱ ;46 stage Ⅲ ;72 stage Ⅳ. Forty-one patients were treated with preoperative radiation plus surgery( R + S) ,22 patients with surgery plus postoperative radiation ( S + R), 5 patients with surgery alone ( SA ), 78 patients with radiotherapy alone (RA). Results The overall 5 year survival rate of 146 patients with squamous cell carcinoma of the nose and ethmoid sinus was 49. 1%. The 5 year survival rate of the patients at stage Ⅰ and Ⅱ was 95. 7% ,while the rate was 59. 8% in the patients at stage Ⅲ and 28. 2% in the patients at stage Ⅳ ( x2 = 24. 15, P < 0. 05). The 5 year survival rate was 57.7% in R+S group,60.4% in S+R group, 100% in SA group,and 38.8% in RA group,respectively(P >0. 05). The 5 years survival rate of N + patients was lower than that of NO( x2 = 12. 326,P < 0. 05). Local recurrence and distant metastasis were main causes of death. Cox analysis showed TNM stage and differentiation of tumor were independent significant prognostic factors. Conclusions The higher survival rate of patients with squamous cell carcinoma of the nose and ethmoid sinus was obtained from combined therapy R + S or S + R. SA gave ideal results for early lesions(stage Ⅰ and Ⅱ ).     

鼻腔筛窦鳞状细胞癌146例治疗分析

Objective To evaluate the treatment outcome of different therapeutic modalities for squamous cell cacinoma of the nose and ethmoid sinus and prognostic factors. Methods One hundred and forty-six cases of squamous cell carcinoma of the nose and ethmoid sinus treated from 1990 to 2007 were reviewed. Of the 146 cases,28 were at stage Ⅰ or Ⅱ ;46 stage Ⅲ ;72 stage Ⅳ. Forty-one patients were treated with preoperative radiation plus surgery( R + S) ,22 patients with surgery plus postoperative radiation ( S + R), 5 patients with surgery alone ( SA ), 78 patients with radiotherapy alone (RA). Results The overall 5 year survival rate of 146 patients with squamous cell carcinoma of the nose and ethmoid sinus was 49. 1%. The 5 year survival rate of the patients at stage Ⅰ and Ⅱ was 95. 7% ,while the rate was 59. 8% in the patients at stage Ⅲ and 28. 2% in the patients at stage Ⅳ ( x2 = 24. 15, P < 0. 05). The 5 year survival rate was 57.7% in R+S group,60.4% in S+R group, 100% in SA group,and 38.8% in RA group,respectively(P >0. 05). The 5 years survival rate of N + patients was lower than that of NO( x2 = 12. 326,P < 0. 05). Local recurrence and distant metastasis were main causes of death. Cox analysis showed TNM stage and differentiation of tumor were independent significant prognostic factors. Conclusions The higher survival rate of patients with squamous cell carcinoma of the nose and ethmoid sinus was obtained from combined therapy R + S or S + R. SA gave ideal results for early lesions(stage Ⅰ and Ⅱ ).     

Identification of early-stage Meniere’s disease as a cause of unilateral tinnitus

Introduction:Meniere’s disease(MD)is characterized by episodic symptoms,including vertigo,hearing loss,and tinnitus.Objectives:in this study,cases of unilateral tinnitus were investigated for MD.Method:Twenty-two patients who presented with chronic unilateral tinnitus on puretone audiograms showing an average threshold better than 25 dB HL and thresholds in the lower frequencies worse than those in the higher frequencies by more than 10 dB were suspected to have early-stage MD and underwent electrocochleography(ECochG).Patients showing ECochG findings conclusive for MD were compared to a control group of patients presenting with chronic unilateral tinnitus on pure-tone audiograms showing an average threshold better than 25 dB and thresholds in the higher frequencies worse than those in the lower frequencies by more than 10 dB.Results:Eighteen of the 22 patients included in this study showed elevated summating potential amplitude to action potential amplitude ratios in ECochG(suggestive of endolymphatic hydrops due to MD)and were followed up for 2 months;14 of them experienced at least two attacks of vertigo or unsteadiness.In contrast,only one patient in the control group reported two or more attacks of vertigo or unsteadiness in the 2 month observation period.The incidence of this finding in the two groups was significantly different.Conclusion:Patients with early-stage MD can present with only unilateral tinnitus.Thus,the addition of“pure-tone audiograms showing lower-frequency thresholds worse than higher-frequency thresholds”to the probable MD category in the globally.     

Auditory Brainstem Responses in Senile Presbycusis Patients over 90 years

Objective To analyze the characteristics of auditory brainstem response (ABR) in presbycusis patients el-der than 90 years. Methods Fourteen presbycusis patients elder than 90 years (presbycusis group, 91.1.4 ± 1.3 years, 26 ears) and 9 normal-hearing young adults (control group, 22.7 ± 1.2 years, 18 ears) participated in the study. Alternative click-evoked ABRs were recorded in both groups. The peak latency (PL) of peak I,Ⅲ, and V, and the inter-peak latency (IPI) of I-Ⅲ,Ⅲ-V, and I-V were compared between groups. Results In elder presbycusis patients, the occurrence rate of peak I andⅢwere both 76.9%, and that of peak V was 84.6%. In presbycusis group, the peak latencies of I, Ⅲ, V were significantly longer than that of control group (P<0.001). There was no significant difference between groups in the IPI of peak I-IⅢ (P=0.298, peakⅢ-V (P=0.254) and peak I-V (P=0.364). Conclusions Auditory brainstem responses in presbycusis pa-tients elder than 90 years showed worse wave differentiation.     

Prognostic and proliferative evaluation of ameloblastoma based on radiographic boundary

Ameloblastoma is a benign odontogenic tumor with an aggressive biological behavior,and the surgical treatment frequently results in failure for the postoperative recurrence.The aim of this article was to investigate whether the proliferative ability and prognosis of ameloblastoma could be evaluated by the radiographic boundary.The ameloblastoma cases treated by the conservative therapy in our hospital between 1981 and 2001 were divided into three groups based on the nature of the radiographic borders of the lesions.The biologic behavior was evaluated by Ki-67 antibody immunohistochemically.Comparisons of prognosis and Ki-67 expression were carried out by statistic methods.There were 24 cases of well-defined edge with sclerosis(group I),41 cases of well-defined edge without sclerosis(group II) and 32 cases of ill-defined edge(group III).The recurrent rates were 29.2% in group I,43.9% in group II and 62.5% in group III(P,0.05).The cells in group III expressed the highest Ki-67 level(P,0.05).The radiographic boundary could be used as one of indicators in evaluating the proliferative ability of ameloblastoma and the patient’s prognosis,which was consistent with Ki-67 expression.     

突发性极重度聋与全聋的预后特点及差异

Objective To clarify the different prognostic characteristics between profound sudden sensorineural hearing loss (SSNHL) and total SSNHL. Methods The patients with SSNHL who visited Eye Ear Nose and Throat Hospital from June 2007 to September 2008 were reviewed retrospectively. All the 204 patients, with pure tone average (PTA) threshold more than 90 dB, were enrolled and divided into two groups, including total SSNHL and profound SSNHL groups. The relationship between recovery rate and prognostic factors including the age, complications, time period between onset and therapy was analyzed.Results There were 57 cases of total SSNHL and 147 cases of profound SSNHL in this series. Tinnitus was complained in more than 90% of the patients in both groups, which was higher than that of dizziness and ear fullness. Dizziness was present in 64. 9% (37/57) patient with total SSNHL group and 45.6% (67/147)patients with profound SSNHL, which had significant difference between the two groups (x2 = 5.72,P =0. 017). The PTA threshold improvement in total SSNHL group and profound SSNHL group was (36. 4 ±19.3) dB and (40. 2 ±21.3) dB respectively, which was no significant difference between the two groups (t = 1. 165 ,P =0. 245). The cured patients were all those received therapy within 1 week following the onset of SSNHL, which was of 2. 6% (1/38) patients in the total SSNHL group and 14. 3% (14/98) patients in the profound SSNHL group(P =0. 045). Furthermore, 3.5% (2/57) patients in total SSNHL group as well as 29. 9% (44/147) patients in profound SSNHL group obtained a good result with PTA threshold ≤50 dB after therapy(x2 = 15.92,P = 0. 001 ). In addition, the favorable prognosis was related with the onsettherapy time point( P = 0. 001 ), but not related to the patients' age. Conclusion Profound SSNHL and total SSNHL though both with PTA threshold > 90 dB had significant differences recovery rate and need to be studied separately.     

突发性极重度聋与全聋的预后特点及差异

Objective To clarify the different prognostic characteristics between profound sudden sensorineural hearing loss (SSNHL) and total SSNHL. Methods The patients with SSNHL who visited Eye Ear Nose and Throat Hospital from June 2007 to September 2008 were reviewed retrospectively. All the 204 patients, with pure tone average (PTA) threshold more than 90 dB, were enrolled and divided into two groups, including total SSNHL and profound SSNHL groups. The relationship between recovery rate and prognostic factors including the age, complications, time period between onset and therapy was analyzed.Results There were 57 cases of total SSNHL and 147 cases of profound SSNHL in this series. Tinnitus was complained in more than 90% of the patients in both groups, which was higher than that of dizziness and ear fullness. Dizziness was present in 64. 9% (37/57) patient with total SSNHL group and 45.6% (67/147)patients with profound SSNHL, which had significant difference between the two groups (x2 = 5.72,P =0. 017). The PTA threshold improvement in total SSNHL group and profound SSNHL group was (36. 4 ±19.3) dB and (40. 2 ±21.3) dB respectively, which was no significant difference between the two groups (t = 1. 165 ,P =0. 245). The cured patients were all those received therapy within 1 week following the onset of SSNHL, which was of 2. 6% (1/38) patients in the total SSNHL group and 14. 3% (14/98) patients in the profound SSNHL group(P =0. 045). Furthermore, 3.5% (2/57) patients in total SSNHL group as well as 29. 9% (44/147) patients in profound SSNHL group obtained a good result with PTA threshold ≤50 dB after therapy(x2 = 15.92,P = 0. 001 ). In addition, the favorable prognosis was related with the onsettherapy time point( P = 0. 001 ), but not related to the patients' age. Conclusion Profound SSNHL and total SSNHL though both with PTA threshold > 90 dB had significant differences recovery rate and need to be studied separately.     

鼻炎分类和诊断及鼻腔用药方案的专家共识

目的本文基于临床经验和循证医学证据制定的鼻炎（萎缩性鼻炎除外）分类和诊疗的专家共识,其中在治疗方面重点关注了鼻腔局部用药的临床应用,旨在进一步规范鼻炎尤其是慢性鼻炎的诊疗,明确鼻腔局部用药如鼻用糖皮质激素、鼻用抗组胺药和鼻腔盐水盥洗等在鼻炎治疗中的临床地位及注意事项,以便指导临床医师进行合理用药,提高鼻炎的疗效和患者的满意度。     

认识眼震性质是识别眩晕疾病的重要方式

眼震是眩晕疾病的常见体征，识别眼震性质可提供眩晕疾病的重要诊断线索。眼震大致可分类为生理性眼震和病理性眼震。根据常见疾病来源和发生机制，病理性眼震可大致分为3类:耳源性眼震、眼源性眼震及中枢源性眼震。本文重点讨论这3类病理性眼震及其性质特征对识别眩晕疾病来源的意义。     

玉屏风散对大鼠变应性鼻炎的作用研究

摘要：目的观察玉屏风散在卵清蛋白致敏大鼠变应性鼻炎模型的抗过敏作用。方法实验在湖南省儿童医院动物实验室进行,30只6周龄雌性封闭群SD大鼠随机分成空白对照组（n=2）、对照组（n=4）、酮替芬灌服组（n=6）、玉屏风散灌服组（n=6）、玉屏风散滴鼻组（n=6）、布地奈德滴鼻组（n=6）5组。建立卵清蛋白诱导的大鼠变应性鼻炎大鼠模型,第1、8、15天,分别腹腔注射1 000 μg卵清蛋白,自22 d开始300 μg卵清蛋白滴每侧鼻孔。与此同时,造模第22天开始给药。采用叠加量化法记录各鼻部症状得分,然后计算总分。第37天,解剖获取胸腔心脏血、鼻中隔和双侧鼻腔外侧壁黏膜并且进行分析。结果实验各组与对照组比较,鼻部症状得分减少,纤毛上皮损伤较轻,血清中组胺水平显著降低,鼻黏膜中杯状细胞数量减少,嗜酸性粒细胞数量减少。结论玉屏风散对变应性鼻炎症状得分及鼻部组织具有抗过敏作用。     

内收型痉挛性发音障碍患者动态喉镜表现及嗓音学特点

目的探讨内收型痉挛性发音障碍（SD）患者的动态喉镜下表现、嗓音学特点以及病因,并与正常人对比分析,为临床诊断及进一步治疗提供参考依据。方法收集61例内收型SD患者的嗓音参数以及30例正常对照者的嗓音参数,对比分析。结果61例患者中51例为女性患者;61例患者中35例（57.4%）患者的反流体征评分量表（RFS）的分值>7;有明显心理因素或心理创伤的患者7例（11.5%）。患者发音时存在一些颈部及全身肌肉过度紧张的表现,动态喉镜下所有患者均无器质性病变,主要表现为双侧声带紧张并过度内收、喉部震颤,部分患者可见声门上结构向中间挤压靠拢。嗓音测试时所有患者在朗读过程中存在紧张性发音,基频(F0)及响度瞬间起伏,语音颤抖、嗓音挤卡、失去韵律,42例（68.9%）患者出现嗓音中断：患者读一段话的嗓音平均中断次数（1.9±2.0）次显著高于正常人（0.0±0.0）次（P<0.01）;所有患者读一段话的朗读时间均值（21.5±4.8）s较常对照组的朗读时间均值（16.2±3.7）s显著延长,差异具有统计学意义(P<0.01);患者的振幅微扰(shimmer)均值及基频微扰(jitter)均值为显著高于正常对照组 (P<0.01);患者的嗓音障碍指数(DSI)均值显著低于正常对照组 (P<0.05);患者的最长发音时间(MPT)较正常对照组显著缩短(P<0.01)。结论内收型SD患者大部分为女性,患者动态喉镜下会有一些特征性表现,患者的音质、音韵和流畅性较正常人有一定改变;患者的shimmer、jitter、DSI、MPT较正常人有显著差异。该疾病可能与胃酸反流有一定关系,少部分患者可能存在心理因素。     

颅底脊索瘤临床诊疗进展

脊索瘤是一种罕见的来源于脊索胚胎残余组织的肿瘤,其中颅底脊索瘤约占1/3。颅底脊索瘤首选手术治疗,手术切除程度与预后高度相关。因为大部分肿瘤位于颅底腹侧面的硬膜外,适用于内镜经鼻入路切除,对脑组织的损伤很小。放疗是颅底脊索瘤重要的辅助治疗手段,术后残留肿瘤放疗可以明显延长患者无进展生存期。脊索瘤化疗仍处于临床试验阶段,传统化疗药物对于脊索瘤的疗效较差,有待发展新的靶向治疗或免疫治疗药物。随着综合治疗技术的不断进步,颅底脊索瘤的治疗效果将逐步提高。     

儿童声音嘶哑1285例调查分析

目的通过对儿童嗓音情况的调查分析,了解导致儿童嗓音疾病的主要原因及病变,为儿童嗓音保健及嗓音疾病早期干预治疗提供依据。方法选取2010年1月~2014年7月在吉林市中心医院喉科就诊的来自于15个社区、主诉为声音嘶哑的儿童1285名,应用间接喉镜进行检查,其中声门区不能完全暴露者235例,不能配合者351例,均在表麻下经鼻腔电子喉镜检查。对其发病特点、嗓音情况进行分析。结果引起儿童声音嘶哑最常见的病因是声带良性增生性病变,占66.61%,其中包括声带小结、声带息肉等,过度用嗓是造成儿童嗓音疾病的主要原因。结论积极开展社区儿童用嗓保健,加强对高危人群的监测,具有重要的意义。     

原发性中耳类癌2例报道并文献复习

目的探讨中耳类癌的临床表现、病理特征、治疗方法及预后。方法回顾性总结分析2011年至今我院经病理证实的2例中耳类癌患者的临床资料，并对2000~2018年发表的相关中文文献中报道的25例患者的临床资料进行复习。结果本病最常见的临床表现为听力下降，其次为外耳道肿物、耳鸣。27例中采用免疫组织化学检测肿瘤标志物的患者15例，常见相关标志物有突触素、嗜铬蛋白、细胞角蛋白、神经元特异性烯醇化酶、神经细胞黏附分子和波形蛋白等；27例均行手术治疗；术后平均随访时间为25个月,复发7例。结论中耳类癌是一种发病率低、临床表现及影像学检查缺乏特异性、易于漏诊和误诊的中耳肿瘤。在临床工作中，当发现临床症状及影像学表现缺乏特异性的中耳肿物患者时，应考虑行术前穿刺活检或术中冰冻，根据肿物性质确定手术方案，使手术方法更加合理，从而改善预后。尽管中耳类癌患者预后尚好，但容易远期复发，须进行长期随诊。     

血小板活化因子在变应性鼻炎中的作用及其研究进展

目的血小板活化因子(PAF)是一种强活性的内源性磷脂介质,主要由中性粒细胞、嗜酸性粒细胞、嗜碱性粒细胞、肥大细胞、内皮细胞和巨噬细胞等多种免疫细胞受到炎症刺激后释放,在多种炎症性疾病中起着至关重要的作用。近些年在变应性鼻炎（AR）的发病机制研究中发现，PAF作为潜在的相关炎症介质，可以通过影响炎性细胞的趋化作用，改变鼻腔黏膜血管通透性及气道反应性并影响腺体的分泌，从而对AR一些症状的产生起着较关键的作用。目前国际上已有多项临床研究证明，使用PAF抑制剂是干预AR症状的一个有效方法，但是国内关于PAF抑制剂在AR中的应用研究相对甚少。本文就近年来血PAF在AR发病机制中的作用及相关研究进行综述。     

舒芬太尼联合瑞芬太尼对小儿七氟醚全麻扁桃体手术血流动力学和苏醒期躁动的影响舒芬太尼联合瑞芬太尼对七氟醚全麻小儿扁桃体摘除术的影响

目的分析舒芬太尼联合瑞芬太尼对七氟醚全麻小儿扁桃体摘除术的效果以及对患儿血流动力学和苏醒期躁动的影响。方法选取2016年10月~2017年12月于新疆喀什地区第一人民医院行扁桃体摘除术的患儿106例,按照随机数字表法将患儿分为两组,观察组53例,采用舒芬太尼联合瑞芬太尼进行诱导麻醉;对照组53例,采用瑞芬太尼进行诱导麻醉。比较两组患儿的手术时间、麻醉时间、停药至拔管时间、苏醒时间、自主呼吸恢复时间、出麻醉恢复室时间等指标,记录并比较两组患儿在麻醉诱导前、插管时、插管后5 min、拔管后5 min的心率（HR）、平均动脉压（mean arterial pressure, MAP）和血氧饱和度（saturation of blood oxygen,SpO2）,比较两组患儿Aono’s评分、小儿麻醉后苏醒期躁动评分（paediatric anesthesia emergence delirium, PAED）和术后疼痛评分（children and infants postoperative pain scale, CHIPPS）,并比较两组患儿麻醉后不良反应发生率。结果观察组患儿苏醒时间（8.2±2.7）min、自主呼吸恢复时间（115.7±32.4）s和出麻醉恢复室时间（28.4±6.3）min均低于对照组,差异具有统计学意义（P<0.05）。观察组患儿插管后5 min、拔管后5 min的HR和MAP均低于对照组,差异具有统计学意义（P<0.05）。两组患儿插管后5 min、拔管后5 min的SpO2比较,差异无统计学意义（P>0.05）。观察组患儿术后Aono’s评分、PAED评分和CHIPPS评分均低于对照组,差异具有统计学意义（P<0.05）。观察组恶心呕吐发生率和总不良反应发生率低于对照组,差异具有统计学意义（P<0.05）。结论舒芬太尼联合瑞芬太尼麻醉能够提高小儿麻醉效果,改善血流动力学水平,减轻患儿苏醒期躁动,降低不良反应反生率。     

变应性鼻炎继发哮喘患者血浆microRNA表达谱的改变

目的应用microRNA表达谱芯片技术，选取临床明确诊断的变应性鼻炎（allergic rhinitis, AR）及变应性鼻炎罹患哮喘(asthma, AS)患者相应血浆，分析变应性鼻炎患者罹患哮喘后血浆microRNA的差异性表达。方法选取AR及AR+AS各3例，使用miRCURY LNATM芯片，筛选出两组患者血浆中差异表达的microRNA并进行聚类分析；最后通过生物信息学分析预测其靶基因。结果与AR组相比较，AR+AS组差异表达的microRNA共有9个，其中表达下调的有4个，表达上调的有5个。靶基因预测显示，以黏附连接、Wnt和MAPK信号传导通路靶基因的差异表达最为显著。结论通过microRNA芯片发现的相关差异性表达的microRNA，有可能成为AR患者罹患AS的易感性生物标志物及临床可能的治疗靶点，但是尚需要进一步靶基因验证及功能学分析。