实验性急性鼻窦炎上颌窦黏膜超微结构观察

目的:观察家兔急性鼻窦炎上颌窦黏膜超微结构的动态改变。方法:25只家兔随机分为实验组(20只)和空白对照组(5只),先建立急性鼻窦炎鼻源性模型。建模后第1、2、3、4周每周随机选取实验组家兔5只处死,解剖并从右上颌窦腔取0.3 cm×0.3 cm大小新鲜黏膜组织用透射电镜观察其超微结构。对照组在第1周开始实验。结果:透射电镜观察,对照组家兔上颌窦黏膜纤毛排列整齐,无丢失,上皮细胞内线粒体无肿胀,内质网未见扩张;实验组家兔上颌窦黏膜纤毛变性,排列紊乱,部分纤毛丢失,出现复合纤毛、胞质突起、内质扩张、线粒体肿胀及黏膜下淋巴细胞浸润伴成纤维细胞增生等病理改变,与对照组比较,差异有统计学意义(P<0.05)。实验组家兔第1～4周,复合纤毛数量逐渐增多,第3、4周与第1周比较,差异均有统计学意义(均P<0.05)。内质网扩张和线粒体肿胀程度在第2周最明显,第4周后逐渐减轻,第2周与第4周比较差异有统计学意义(P<0.05)。结论:窦口阻塞及细菌感染导致上颌窦黏膜超微结构改变,是急性鼻窦炎病理演变过程的一个重要环节。

Observation on ultrastructure of maxillary sinus mucosa in experimental acute sinusitis

Objective:To observe ultrastructure of maxillary sinus mucosa of experimental acute sinusitis in rabbits.Method:Twenty-five rabbits were randomly divided into experimental group(20 rabbits)and blank control group(5 rabbits).We established a rhinogenic model of experimental acute sinusitis in experimental group.Five rabbits chosen randomly in experimental group were sacrificed and dissected after 1,2,3,and 4 weeks,and the tissue(0.3 cm×0.3 cm) of sinus mucosa were prepared for visualization by transmission electron microscope(TEM).Animals in blank control group were sacrificed after 1 week.Result:Under the transmission electron microscope,in the blank control group,cilia of maxillary sinus mucosa lined up in order without ciliary loss,no stretched endoplasmic reticulum or turgescent mitochondria was observed.However,in the experimental group,inordinate array and loss of cilia was observed,a few compound cilia and cytoplasmic protrusion were also found.Both endoplasmic reticulum and mitochondria were swelling,and the lymphocytes were infiltrating with fibroblast proliferation in the submucosa.There was statistically significant difference between the experimental group and the blank control group(P<0.05).In the experimental group,the number of compound cilia increased from 1 to 4 weeks,and the amount of compound cilia of the mucosa at 3 and 4 weeks was significantly higher than that at 1 week(P<0.05).Swelling of mitochondria and endoplasmic reticulum was severe at 2 weeks and abated gradually with time,the results at 2 weeks were different from those of experimental group at 4 weeks(P<0.05).Conclusion:The obstruction of nasal sinuses and the bacterial infection might lead to ultrastructural changes of maxillary sinus mucosa,and these ultrastructural changes were believed to the important processes of pathological changes in acute sinusitis.