To Study Of The Nasal Mucosa Remodeling Of Difficult-To-Treat Rhinosinusitis Patients

Abstract Objective：To explore whether there was tissue remodeling in the nasal mucosa of difficult-to-treat rhinosinusitis(DTRS) patients and analyze its relations with eosinohils,goblet cells,muscus gland hyperplasia,matrix metal oproteinsase 9(MMP-9) and tissue inhibitors of. matrix metal oproteinases(TIMP-1) in the nasal mucosa of these patients.Methods:All patients receiced preoperatice blood routine examination,endoscopy and sinus computerize tomography(CT).All patients were objectively assessment of VAS and subjectively assessment including the Lund-Kennedy endoscopic scale.Pathologic staining was used to explore the mucosa of the middle turbinate tissues fromm all patients.According to their clinical characteristics,they were divided into DTRS group(12 cases),initial treatment group(18 cases),and mormal control group (16 cases).The infiltrating of eosinophils and damage of epithelium were examined by the hematoxylin-eosin staining;goblet cells and muscus gland hyperplasia were counted by the alcian blue-periodic acid-schiff staining,the percentage area of extracellular matrix was determined by the MT;theprotein exoressions were measured by immunohistlchemical experiment of MMP-9,TIMP-1 in the middle turbinate tissues.Result:① The whole blood eosinophil count had no significant difference (P > 0.05). ② Nasal mucosa tissue of eosinophil count, collagen fiber area percentage, mucus glands in the area, MMP-9 and TIMP-1 number of positive cells expressing all shows:refractory group, the initial treated group were higher than the control group, difference has statistical significance (P<0.05); Refractory group is higher than the initial differences statistically significant (P < 0.05);③ In the nasal mucosa goblet cell counting:refractory group, the initial treated group were higher than the control group, the difference is statistically significant (P< 0.05); Refractory and initial group had no statistical significance (P>0.05).Conclusion:The nasal mucosa remodeling was observed in DTRS group and was characterlzed by long-term infiltrating eosinophils in nasal mucosa tissue, mucous glands of high expression of collagen fibers deposition,MMP-9 and TIMP-1 increased and the lower the ratio the unbalance of the change.