Carenfelt C
Ann Otol Rhinol Laryngol. 1979 Jan-Feb;88(1 Pt 1):16-20. doi: 10.1177/000348947908800104.
The crucial event in the pathogenesis of sinus empyema is the ostial obstruction. On the basis of recent reports, some consequences of the obstruction on the local bacterial-host interrelationship have been outlined. The anaerobic gas environment of the empyema is one quality important to the selection of bacteria but probably also to the efficiency of the antibacterial activity of the granulocytes. Release of proteolytic enzymes from neutrophilic granulocytes in the sealed sinus may jeopardize the bacterial engulfment due to proteolytic degradation of opsonins. A longstanding exposure of the sinus mucosa to uninhibited proteolytic enzymes may explain the irreversible lesion of the mucosa in chronic sinusitis.
鼻窦积脓发病机制中的关键事件是窦口阻塞。根据最近的报道，已经概述了阻塞对局部细菌与宿主相互关系的一些影响。积脓的厌氧气体环境是细菌选择的一个重要因素，但可能对粒细胞抗菌活性的效率也很重要。封闭鼻窦中嗜中性粒细胞释放蛋白水解酶可能会因调理素的蛋白水解降解而危及细菌的吞噬作用。鼻窦黏膜长期暴露于不受抑制的蛋白水解酶可能解释了慢性鼻窦炎中黏膜的不可逆病变。
