金黄色葡萄球菌超抗原与慢性鼻窦炎鼻息肉发生相关性的研究

目的:探讨金黄色葡萄球菌(金葡菌)超抗原在鼻息肉发生中的作用。方法:对42例双侧鼻息肉患者(鼻息肉组)、27例单纯慢性鼻窦炎患者(鼻窦炎组)和12例无鼻窦疾病史的鼻外伤患者(对照组)的鼻腔分泌物进行细菌培养;采用酶联免疫吸附试验(ELISA)法检测各组患者的鼻黏膜或息肉组织中的金葡菌超抗原;在组织学上,对苏木精-伊红染色切片进行嗜酸粒细胞计数。结果:鼻腔分泌物中金葡菌阳性率鼻息肉组为7.1%,鼻窦炎组为3.7%,对照组为0,各组间差异均无统计学意义(均P>0.05)。ELISA结果显示:鼻息肉组金葡菌超抗原阳性率为54.76%,鼻窦炎组和对照组阳性率均为0。嗜酸粒细胞计数平均值:鼻息肉组23.94±13.88,鼻窦炎组0.29±0.51,对照组0.08±0.28,3组间均差异有统计学意义(均P<0.05)。鼻息肉组中ELISA结果阳性者嗜酸粒细胞水平比阴性者高,但差异无统计学意义(P>0.05)。结论:金葡菌超抗原与鼻息肉的发生存在相关性,有可能在鼻息肉的致病机制中起重要作用。

A primary study about the correlation between superantigens produced by Staphylococcus aureus and chronic rhinosinusitis with nasal polyps

OBJECTIVE: To study the role of superantigens produced by Staphylococcus aurous in the pathogenesis of nasal polyps. METHOD: sinonasal mucus and polyp/mucosa tissue were obtained from sixty-nine patients with chronic rhinosinusitis (42 patients with bilateral nasal polyps, 27 without nasal polyps). Samples from twelve normal subjects were also obtained for comparative negative controls. Mucus specimens were cultured for bacteria. Tissue specimens were assayed by ELISA for staphylococcal exotoxins. In addition, the histopathology of nasal polyps was studied. The paraffin sections were stained with hematoxylin and eosin, and these were examined for eosinophil counts. RESULT: The percentages of Staphylococcus aurous in sinonasal mucus were 7.1 for chronic rhinosinusitis with nasal polyp (CRSwNP) subjects, 3.7% for chronic rhinosinusitis without nasal polyps (CRSsNP). and 0 for controls respectively. There were no significant differences between these groups. In CRSwNP subjects 23 of 42 samples (54.76%) demonstrated reactivity for at least one staphylococcal exotoxin. There were no positive results in the CRSsNP or control groups. The mean eosinophil counts were 23. 94+/-13. 88 in CRSwNP group, 0.29+/-0.51 in CRSsNP group, and 0. 08+/-0.28 in controls. The differences in these three groups were all significant ( P <0.05). There was a trend toward higher eosinophil levels in polyps of ELISA-positive patients compared with that of ELISA-negative patients, although this was not statistically different ( P >0.05). CONCLUSION: There were correlation between Staphylococcal superantgens and nasal CRSwNP, and superantgens were possible etiological agents in the pathogenesis of CRSwNP.