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目的 分析不同亚型慢性鼻-鼻窦炎鼻息肉(CRSwNP)患者组织中Th细胞亚群及相关细胞表达水平.方法 76例行鼻内镜手术切除的CRSwNP患者息肉组织标本和28例行鼻中隔偏曲矫正术切除的下鼻甲组织标本,采用组织病理学观察、RT-PCR和免疫组化染色法观察Th17细胞(转录因子RORc)、IL- 17mRNA表达和IL-17、IL-17RD蛋白表达情况.结果 CRSwNP组嗜酸性粒细胞(Eos)、浆细胞和巨噬细胞比例高于下鼻甲组(P＜0.05),黏膜腺体水平低于下鼻甲组(P＜0.05);以嗜酸性粒细胞＞6％判断为 Eos浸润型,CRSwNP组Eos浸润型患者30例(39.47 ％),非Eos浸润型46(60.53 ％),CRSwNP Eos浸润型患者嗜酸性粒细胞高于非Eos浸润型(P＜0.05),黏膜腺体低于非Eos浸润型(P＜0.05),二组浆细胞、巨噬细胞水平、息肉组织Th17细胞和IL-17 mRNA相对表达量水平比较差异无统计学意义(P＞0.05);CRSw- NP Eos浸润型IL-17和IL-17RD蛋白表达水平低于非Eos浸润型(P＜0.05).结论 非Eos浸润型 CRSwNP具有粘膜腺体、IL- 17蛋白高表达趋势,Th17细胞及其细胞因子可能通过影响鼻腔黏膜炎性细胞促炎反应参与鼻息肉发病过程.“,”Objective To analyze the expression levels of Th cell subsets and related cytokines in tissues of patients with different subtypes of chronic rhinosinusitis with nasal polyps (CRSwNP). Methods Totally 76 polyp tissue specimens of patients with CRSwNP treated by endoscopic resection and 28 inferior turbinate tissue specimens of patients treated by nasal septum deviation were collected. The expression of Th17 cells (transcription factor RORc), IL- 17mRNA, IL- 17 and IL- 17RD protein was observed by tissue pathology, RT ～ PCR and immunohistochemical staining. Results The ratios of eosinophils (Eos), plasma cells and macrophages were significantly higher while the mucosal gland level was significantly lower in CRSwNP group than the inferior turbinate group (P＜0. 05). With Eos＞6％ as Eos infiltrative type,there were 30 cases (39. 47％) of Eos infiltrative type and 46 cases (60. 53％) of non - Eos infiltrative type in CRSwNP group. Eos were significantly higher while the mucosal glands were significantly lower in CRSwNP Eos infiltrative patients than non- Eos infiltrative patients (P＜0. 05). There was no significant difference between the two groups in plasma cells, macrophages, relative expression levels of Th17 cells (transcription factor RORc) or IL - 17 mRNA in polyps (P＞0. 05). The expression levels of IL- 17 and IL - 17RD protein in CRSwNP Eos infiltrative type were significantly lower than those in non- Eos infiltrative type (P＜0. 05). Conclusion There is a trend of high expression of mucosal glands and IL - 17 protein in CRSwNP of non - Eos infiltrative type. Th17 cells and related cytokines may play an important role in the pathogenesis of nasal polyps through affecting pro - inflammatory reactions of nasal mucosa inflammatory cells.