摘要
目的通过对上呼吸道感染后嗅觉障碍的患者鼻腔大体及嗅上皮超微结构的研究,从形态学上观察嗅觉减退或丧失的超微结构改变。方法选择上呼吸道感染后嗅觉减退或丧失患者10例,用 T&T 嗅觉测试法测试患者的嗅觉功能。常规前鼻镜、鼻内镜下对鼻腔大体结构进行观察,鼻内镜下钳取嗅区黏膜行透射电镜超微结构观察。结果上呼吸道感染后嗅觉障碍患者嗅黏膜超微结构有以下变化:①嗅上皮结构层次仍能保持,但细胞间隙增宽;②上皮表面嗅泡明显减少,即使嗅泡存在,其末端的纤毛也明显减少,部分嗅泡呈空泡状改变;③微绒毛细胞和支持细胞表面的微绒毛减少或缺失;④支持细胞的细胞核变形或固缩,嗅细胞的树突水肿变形,细胞器减少。结论上呼吸道感染后嗅觉功能障碍与嗅黏膜上皮超微结构的改变密切相关。患者嗅泡及嗅泡内纤毛缺失,微绒毛细胞及支持细胞的微绒毛减少是引起嗅觉减退的主要原因,支持细胞胞核的变形及嗅细胞树突的形态学改变与嗅觉改变相关。
Objective The study focus on the olfactory changes post upper respiratory infection, through observation of nasal mucosa and it＇s uhrastructural changes. Methods Olfactory test was performed by odor threshold and identification test （T＆T olfactometry）. The specimens of olfactory epithelium （OE） were obtained from l0 patients with anosmia or olfactory disorder post upper respiratory infection. All specimens were obtained under endoscope. Transmission electron microscope （TEM） was used to observe the ultrastructural changes of each group. Results Under the TEM, the surface ultrastructure of the OE from patients showed following abnormal changes：（1）Normal epithelium structural characteristics maintained but clearance between cells appeared wider. （2）Olfactory vesicles reduced obviously, even if the olfactory vesicles existed, the olfactory cilia showed reduction. Some olfactory vesicles still existed, but the number of olfactory cilia reduced. Some olfactory vesicles changed their shape due to vacuolization. （3）Surface microvillus of the supporting cells disappeared. （4） The nuclei of supporting cell changed the shape or karyopyknosis, olfactory dentrites were shorter and wider than normal, and organelles reduced. Conclusions There is close relationship between uhrastructural changes and olfactory disorders post upper respiratory infection. Reduced olfactory vesicles, cilia and disappeared microvillus of the supporting cells are the main reasons for the patient＇s olfactory disorder.
出处
《中华耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2007年第11期826-829,共4页
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
关键词
嗅黏膜
嗅觉障碍
细胞结构
显微镜检查
Olfactory mucosa
Olfactory disorder
Cellular structure
Microscopy
