慢性鼻-鼻窦炎细菌生物膜形态观察

目的 观察慢性鼻-鼻窦炎患者,鼻内镜所取钩突、筛泡或上颌窦黏膜样本是否存在细菌牛物膜及其形态特征.方法 本实验共取鼻内镜术中黏膜样本12份,实验组为慢性鼻.鼻窦炎鼻内镜手术患者6例,对照组为阻塞性睡眠呼吸暂停综合征鼻内镜手术患者6例.样本用标准的扫描电镜方法 处理.实验组详细记录患者的年龄、性别、症状、鼻窦CT、鼻内镜检查和变应原皮肤点刺试验结果 .结果 扫描电镜下见慢性鼻一鼻窦炎患者鼻腔鼻窦黏膜纤毛缺失、倒伏、排列紊乱,实验组中5例可见不同形成阶段、各种形态的细菌生物膜,1例可见丝状真菌样结构.实验组细菌生物膜出现率为83.3%.对照组6例均未观察到细菌生物膜.结论 慢性鼻-鼻窦炎鼻腔鼻窦黏膜纤毛有不同程度的损伤,黏膜表面存在处于生命周期不同阶段的细菌牛物膜.

Evidence of bacterial biofilms in chronic rhinosinusitis

Objective To observe the presence of bacterial biofilms in mueosal specimens in patients operated for chronic rhinosinusitis.Methods A total of 12 subjects undergoing endoscopic sinus surgery were included.The control group was 6 patients with obstructive sleep apnea-hypopnea syndrome. Six patients with chronic rhinosinusitis were enrolled in the study group.Mucosa of uncinate process, ethmoid bulla or maxillary sinus was obtained during endoscopic sinus surgery.All the samples were prepared using standard methods for scanning electron microscopy.Patients' information such as age, gender, symptoms, sinus CT, endoscopic examination, skin prick test were recorded in detail.Results Standard-preparation scanning electron microscopy displaed denuded epithelium and disarrayed cilia in chronic rhinosinusitis patient's mucosa.In the study group, bacterial biofilms of different morphology were seen in five samples; One sample showed filamentous structure like fungi.Using strict scanning electron microscopy morphologic criteria, 83.3% samples in the study group were found to have micrographic evidence of biofilms.No bacterial biofilms were detected in the control group.Conclusions In the patients undergoing surgery for chronic rhinosinusitis, different degree of mucosal injury could be found.Bacteria biofilms of different life stages were demonstrated to be present No bacterial biofilms were detected in the control group.