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目的：观察糖皮质激素在体内和体外对鼻息肉中嗜酸性粒细胞凋亡的影响，加深对糖皮质激素治疗鼻息肉作用机制的认识。方法：采用末端脱氧核昔酸转移酶介导的ｄＵＴＰ末端标记法标记鼻息肉中的凋亡嗜酸性粒细胞。比较经布地奈德喷鼻治疗６～８周和未经治疗的鼻息肉组织（各１６例）中，嗜酸性粒细胞的凋亡状况。同时将未经治疗的鼻息肉组织取出，体外培养２、６和１０天，观察地塞米松对体外培养的鼻息肉中嗜酸性粒细胞凋亡的影响。结果：①随培养时间的延长，地塞米松体外培养的鼻息肉组织中的凋亡嗜酸性粒细胞明显增多，而对照培养的鼻息肉组织中，至培养１０天，也仅见散在凋亡嗜酸性粒细胞。②培养２天和６天时，地塞米松培养组嗜酸性粒细胞凋亡比率均明显高于对照培养组（Ｐ＜０．０１），至培养 １０天时，二者无显著差异（Ｐ＞０．０５）。③鼻腔布地奈德治疗后的鼻息肉组织中未见凋亡嗜酸性粒细胞。结论：体外研究证实了糖皮质激素类药物诱导嗜酸性粒细胞凋亡理论在炎性反应消散机制中的作用，但体内研究却未观察到预期的结果。
Objective: To observe the effects of glucocorticoids on the eosinophil apoptosis in nasal polyps in vivo and in vitro, and to deepen the understanding of the mechanism of glucocorticoid treatment of nasal polyps. Methods: Apoptotic eosinophils in nasal polyps were labeled by terminal deoxynucleotidyl transferase mediated dUTP end labeling. The eosinophil apoptosis was compared between 6-8 weeks after budesonide nasal spray and untreated nasal polyps (16 cases each). At the same time, untreated nasal polyps were removed and cultured in vitro for 2, 6 and 10 days to observe the effect of dexamethasone on eosinophil apoptosis in nasal polyps cultured in vitro. Results: ① With the prolongation of culture time, the number of apoptotic eosinophils in nasal polyps cultured with dexamethasone significantly increased, while in the nasal polyps tissue cultured with dexamethasone for 10 days, only scattered apoptotic eosinophils Granulocytes. ② At 2 days and 6 days, the ratio of eosinophils apoptosis in dexamethasone group was significantly higher than that in control group (P <0.01). There was no significant difference between the two groups when cultured for 10 days (P> 0.05). 05). ③ There was no apoptotic eosinophilic granuloma in the nasal polyp tissue after nasal budesonide treatment. CONCLUSIONS: In vitro studies have demonstrated the role of glucocorticoid-induced eosinophil apoptosis theory in the mechanism of inflammatory response dissipation but in vivo studies no expected results have been observed.