摘要
目的:探寻慢性扁桃体炎中医证型与病变程度的相关指标。方法:91例住院的慢性扁桃体炎患者和18例正常健康志愿者,术前行双侧扁桃体组织取样;进行咽拭子细菌培养、活检组织细菌培养、电镜、免疫荧光、免疫组化检查。用SPSS13.0对上述资料进行统计,计数资料用χ2检验,计量资料用t检验。结果:痰瘀互结型与脾胃虚弱、肺肾阴虚型的比较有统计学差异,P<0.05,多见于链球菌、金黄色葡萄球菌感染。慢性扁桃体炎标本电镜下扫描,隐窝的多形扁平上皮细胞表面可见大量异常小颗粒;透射电镜下,上皮细胞间有中性粒细胞与非中性粒细胞浸润,上皮细胞内有球菌状细菌浸润。慢性扁桃体炎活检标本中CD8+T淋巴细胞比率增加,滤泡边缘及冠区的CD4+T细胞与CD8+T细胞比值,健康对照组为3:1,慢性炎性扁桃体组为1:1;其中痰瘀互结型CD8+T淋巴细胞数增加更为明显。对比健康对照组,慢性扁桃体炎组与各证型标本均有不同程度角化,其中痰瘀互结型病变时间长、程度重,抗隐窝角蛋白检查结果与另外两型比较有统计学差异,P<0.05。结论:慢性扁桃体炎中医各证型的组织活检细菌构成比不同;电镜观察痰瘀互结型的病例形态改变明显。各证型间CD4+、CD8+T淋巴细胞相对比率不同;各证型间隐窝上皮细胞角化程度不同。
Objective：The aim of this study was to determined the nature of different subtypes of chronic tonsillitis with histopathology. Methods：A total of 91 patients with chronic tonsillitis and 34 healty volunteers were studied for the specimens from bilateral tonsils before operation by using biopsy,electron microscopy immunofluorescence, immunohisto- chemistry and so on.Results：Compared with the healthy volunteers, bacterial culture of tonsil surface,but germiculture,was not significant different in the patients with chronic tonsillitis （P〉0.05）. There is a difference in different symptomatic types （tanyuhujiepiweixuruo and feishenyinxu）（P〈0.05）. Under electron microscopy, it appears that abnormal keratosis of crypt epithelial cells and bacteria in the chronic tonsillitis group. On transmission electron microscopy, neutrophile granulocyte and non neutrophile granulocyte could be found among the crypt epithelial cells ,even eoeeie bacteria.The ratio of CD4＋T to CD8＋T cells was 3：1 in the control group and 1：1 in the chronic tonsillitis group, analyzing data from specimens of follicle and coranal. The proportion of CD8＋ cells was higher than that of piweixuruo and feishenyinxu groups（P〈0.05）in the tanyuhujie group.Compare to the control group,there were different degrees of keratosis in the chronic tonsillitis group. The results of cytokeratin was significant different among the three subtypes of chronic tonsillitis and higher grade in tanyuhujie group （P〈0.05）. Conclusion：Germicuhure of tonsilar biopsy is a feasible method to investigate the pathogeny of chronic tonsillitis; electron microscopy corroborated the germiculture of biopsy, finding obviously abnormal keratosis of crypt epithehal ceils and pathogenic bacteria. The ratio of CD4＋T to CD8＋Tcells indicated that cellular immunity play an important role in developement of chronic tonsillitis; cytokeratin study authenticated degrees of keratosis of chronic tonsillitis. In the three types of chronic tonsillitis, the results of germiculture of tonsilar biopsy.electron microscopy.ratio of CD4＋ cells to CD8＋T cells and expression of cytokeratin are different clinical implications.
出处
《亚太传统医药》
2009年第11期9-12,共4页
Asia-Pacific Traditional Medicine
基金
广州市番禺区科技计划资金资助项目(2007-Z-76-1)
关键词
慢性扁桃体炎
微生物培养
电镜
免疫荧光
免疫组化
有医证型
Chronic tonsillitis
Germiculture
Electron microscopy
Immunofluorescence
Immunohistochemistry
Symptomatic types
