关键词: 鼻窦炎，慢性；外科手术；鼻黏膜；阿奇霉素 ；核转录因子；白细胞介素-8； 免疫组织化学

Abstract:

Objective   To observe the effect of azithromycin on expressions of NF-kBp65 and IL-8 in nasal mucosa of chronic sinusitis after endoscopic sinus surgery. Methods   45 patients with chronic sinusitis and/or nasal polyps who were treated with endoscopic surgery 2 weeks previously were divided into 3 groups: 15 patients treated with local glucocorticoid as the control group, 15 patients were added with cephalosporin(500mg, once a day) as another control group, others were added with Azithromycin(500mg, once a day) as the experimental group. The PV-6000 immunohistochemical method was applied to explore expressions of NF-kBp65 and IL-8 in nasal mucosa before and after 3-week medical therapy while counting the quantity of positive cells. Results   Chronic inflammation was observed in nasal mucosa after endoscopic sinus surgery by HE staining. There were many inflammatory cells such as neutrophil cells and eosinophil cells under the mucosal epithelium, and the neutrophil cells were the key cells. Expression of NF-kBp65 was positive in the cytoplasm and some nuclei of the mucosal epithelia and the inflammatory cells in nasal mucosa. Expression of IL-8 was positive in the cytoplasm of the mucosal epithelia and inflammatory cells in nasal mucosa. Expressions of NF-kBp65 and IL-8 were significantly reduced in the mucosal epithelia and inflammatory cells of nasal mucosa after 3 weeks medical treatment compared with that of pre-treatment in the three groups(P<0.05).  The difference of expressions of NF-kBp65 and IL-8 in the mucosal epithelia and inflammatory cells of the nasal mucosa were statistically significant in the azithromycin group compared with the cephalosporin group and the control group after treatment(P<0.05).There were no statistical significance of expressions of NF-kBp65 and IL-8 in the mucosal epithelia and inflammatory cells of the nasal mucosa between the cephalosporin group and the control group after treatment(P>0.05). Conclusion   Azithromycin in combination with local glucocorticoid is better than glucocorticoid to inhibit expressions of NF-kBp65 and IL-8 in mucosal epithelia and inflammatory cells in nasal mucosa of chronic sinusitis and/or nasal polyps after endoscopic sinus surgery. It is an effective method to cure chronic inflammation of nasal mucosa in the nasal cavity after endoscopic sinus surgery.

Key words: Sinusitis, chronic； Surgical procedures, operative； Nasal mucosa； Azithromycin； Nuclear factor； Interleukin-8； Immunohistochemistry