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目的探讨肺炎衣原体(Cpn)感染对鼻息肉切除术后复发的影响。方法随机选择鼻息肉切除术后复发患者42例(第1组),未复发患者54例(第2组),对照组为同期耳鼻咽喉科健康体检者80例。分离外周血单核细胞(PBMC),用直接免疫荧光法检测外周血单核细胞(PBMC)中的Cpn特异性抗原(Cpn-Ag),用间接微量免疫荧光法检测血浆中Cpn抗体。通过前瞻性病例对照研究来分析Cpn感染与鼻息肉切除术后复发的相关性。结果代表急性感染的外周血单核细胞(PBMC)Cpn-Ag及Cpn-IgM的阳性检出率在第1组显著高于第2组和对照组(P<0.001和P<0.01),代表慢性感染的Cpn-IgG的阳性检出率第1组和第2组均比对照组显著增高(P<0.001)。结论急性Cpn感染可能与鼻息肉切除术后复发有一定相关性。而慢性cpn感染可能是鼻息肉发展的一种独立危险因素。检测PBMC中Cpn-Ag可为更好的预防鼻息肉切除术后复发提供实验依据。
Objective To investigate the effect of Cpn infection on the recurrence of nasal polyps after resection of nasal polyps. Methods Forty-two patients with recurrent nasal polyps (group 1) and 54 patients without recurrent nasal polyps (group 2) were randomly selected. The control group consisted of 80 healthy subjects with otolaryngology during the same period. Peripheral blood mononuclear cells (PBMCs) were isolated, Cpn-specific antigen (Cpn-Ag) in peripheral blood mononuclear cells (PBMCs) was detected by direct immunofluorescence, and plasma Cpn antibody was detected by indirect microinjection of immunofluorescence. Prospective case-control studies were used to analyze the association between Cpn infection and recurrence after nasal polypectomy. Results The positive rates of Cpn-Ag and Cpn-IgM in acute peripheral blood mononuclear cells (PBMCs) were significantly higher in group 1 than those in group 2 and controls (P <0.001 and P <0.01) The positive rates of Cpn-IgG infection in group 1 and group 2 were significantly higher than those in control group (P <0.001). Conclusions Acute Cpn infection may be related to relapse after nasal polyp resection. Chronic CPN infection may be an independent risk factor for the development of nasal polyps. The detection of Cpn-Ag in PBMC can provide experimental evidence for better prevention of recurrence after nasal polyp resection.