不同类型鼻息肉患者外周血Th17细胞含量的变化及意义

目的：研究不同类型鼻息肉患者外周血Th17细胞含量及其与炎性细胞浸润的关系；探讨其与预后的关系。方法对81例鼻息肉和20例鼻中隔偏曲患者进行研究。外周血Th17细胞含量采用流式细胞仪检测；鼻息肉组织嗜酸性粒细胞、中性粒细胞、淋巴细胞、浆细胞浸润程度以每高倍视野每104μm2面积所含有的数量表示；内镜表现采用Lund-Kennedy评分；主观症状采用VAS评分；影像学CT表现采用Lund-Mackay评分。结果嗜酸性鼻息肉组和非嗜酸性鼻息肉组患者外周血Th17细胞百分比分别为2.10%（3.75%，1.40%）和1.10%（1.70%，0.73%），两组差异有统计学意义（Mann-Whitney U=358.0，Z=-2.965，P=0.001）；外周血Th17细胞百分比与鼻息肉组织中嗜酸性粒细胞呈正相关（r=0.408，P＜0.001），与术后3个月内镜评分有中等程度相关性（r=0.458，P＜0.001）。结论 Thl7细胞表达可能与噬酸性鼻息肉发病及预后有关。

Change of peripheral blood Th17 cells and its signiifcance in patients with different kinds of chronic rhinosinusitis with nasal polyps

OBJECTIVETo observe the change of peripheral blood Th17 cells in patients with different kinds of CRSwNPs and the relationship between the frequency of Th17 cells and inflammatory cell density in nasal polyps tissue, and to explore the correlation between levels of peripheral blood Th17 cells and prognosis of patients with CRSwNPs.METHODSEighty one patients with CRSwNPs and 20 controls were recruited in this research. Flow cytometer was used to detect the expression of peripheral blood Th17 cells. The number per 10000μm2 of infiltrated inflammatory cells in nasal polyp tissue (including eosinophils, neutrophils, lymphocytes and plasma cells) was counted at a high-power field. The CT scores were evaluated by Lund-Mackay system and the nasal endoscopy scores were graded according to Lund-Mackay methods. RESULTSThe percentages of Th17 cells in patients with E-CRSwNPs and NE-CRSwNPs were 2.10% (3.75%, 1.40%)和1.10% (1.70%, 0.73%). There was significant difference between the two groups (Mann-WhitneyU=358.0,Z=-2.965, P=0.001). Furthermore, a positive association between the percentage of Th17 cells in peripheral blood and the eosinophil density of nasal polyp (r=0.408,P<0.001) was demonstrated. The percentage of Th17 cell in peripheral blood was significantly correlated with the endoscopic score of CRSwNPs at third month after the operation (r=0.458, P<0.001).CONCLUSIONThl7 might be involved in the pathogenesis and prognosisof eosinophilic CRSwNPs.