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目的:通过比较慢性鼻窦炎治疗前后鼻息肉组织及术腔黏膜上皮、固有层和分泌物中主要碱性蛋白及弹性蛋白酶表达情况,探讨鼻内镜术后应用博科喷鼻剂、雷诺考特喷鼻剂对术腔黏膜组织中主要碱性蛋白及弹性蛋白酶表达的影响,用以评价局部喷鼻剂在术后术腔恢复中的作用。方法:采用免疫组织化学和Axioplan 2显微图像分析系统检测治疗前后鼻息肉组织及术腔黏膜中主要碱性蛋白及弹性蛋白酶的表达情况。结果:(1)手术日及术后1周鼻息肉组织的上皮层、固有层和分泌物内的主要碱性蛋白及弹性蛋白酶平均阳性表达,治疗组和对照组比较差异无统计学意义(P>0.05);术后4周及术后8周与对照组相比差异均有统计学意义(P<0.05);(2)2组主要碱性蛋白平均阳性表达术后4周与1周相比,术后8周与4周相比差异均有统计学意义(P<0.05);(3)2组术后1周与手术日相比弹性蛋白酶表达增加,差异有统计学意义(P<0.05),术后8周与术后4周相比弹性蛋白酶表达减少,差异有统计学意义(P<0.05);治疗组术后4周与术后1周相比弹性蛋白酶表达显著减少,但对照组弹性蛋白酶表达差异无统计学意义(P>0.05)。结论:鼻内镜术后博科和雷诺考特喷鼻剂联合应用在降低主要碱性蛋白表达方面具有协同作用,在降低弹性蛋白酶表达方面的作用比单用雷诺考特喷鼻剂更加有效,博科和雷诺考特喷鼻剂联合应用可作为一种较好的应用于治疗慢性鼻窦炎的术后鼻腔用药选择。
OBJECTIVE: To compare the expression of major basic protein and elastase in nasal polyps, mucosa epithelium, lamina propria and secretion in patients with chronic sinusitis before and after treatment, and to explore the application of Broccol nasal spray, The effect of nasal spray on the expression of major basic protein and elastase in mucosa of the mucosa to evaluate the effect of topical nasal spray in the postoperative recovery of the mucosa. Methods: Immunohistochemistry and Axioplan 2 microscopic image analysis system were used to detect the expression of major basic protein and elastase in nasal polyps and mucosa of nasal polyps before and after treatment. Results: (1) On average, the expression of major basic protein and elastase in the epithelium, lamina propria and secretions of nasal polyps on the operation day and 1 week after operation were not significantly different (P > 0.05). There were significant differences between the two groups at 4 weeks and 8 weeks after operation (P <0.05). (2) (P <0.05). (3) The expression of elastase in the two groups at 1 week after surgery was significantly higher than that at the 4th day (P <0.05), and the difference was statistically significant (P < 0.05). The expression of elastase decreased at 8 weeks and 4 weeks after operation, the difference was statistically significant (P <0.05). The expression of elastase in treatment group was significantly decreased at 4 weeks and 1 week after operation There was no significant difference in elastase expression in the control group (P> 0.05). CONCLUSIONS: The combination of Broccoli and Renotecote nasal spray after nasal endoscopy has a synergistic effect in reducing the expression of major basic proteins and is more effective in reducing the expression of elastase than in the nascent renocorting alone, Brocade and Renault testosterone nasal spray combination can be used as a better application in the treatment of chronic sinusitis postoperative nasal medication options.