Robson A M, Smallman L A, Gregory J, Drake-Lee A B
Department of Pathology, Medical School, University of Birmingham, UK.
Cytopathology. 1993;4(3):149-59. doi: 10.1111/j.1365-2303.1993.tb00080.x.
Normal ciliary ultrastructure is thought to be necessary for effective function. There has been little or no attempt to quantify ultrastructural abnormalities in nasal disease and assess their significance. In this study we measured nasal ciliary function and examined ciliary ultrastructure in nasal brushings from 35 patients with perennial nasal symptoms refractory to treatment. Ultrastructural defects included microtubular abnormalities, compound cilia and ciliary 'blebs'. The incidence of abnormal cilia was 16.7%, compared with 9% in controls, but there was only a poor correlation between ultrastructural defects and ciliary beat frequency. One patient had primary ciliary dyskinesia (PCD) with a typical clinical history and immotile cilia. However, only secondary ultrastructural abnormalities were seen. We have been unable to show that ciliary ultrastructural defects form the basis of impaired function. In patients with suspected PCD, nasal brushings should be taken for functional and ultrastructural studies; ideally, a further sample should be obtained for examination of possible primary ultrastructural abnormalities.
正常的纤毛超微结构被认为是有效发挥功能所必需的。几乎没有人尝试对鼻部疾病中的超微结构异常进行量化并评估其意义。在本研究中，我们测量了35例常年性鼻部症状且治疗无效患者的鼻纤毛功能，并检查了鼻刷检物中的纤毛超微结构。超微结构缺陷包括微管异常、复合纤毛和纤毛“泡”。异常纤毛的发生率为16.7%，而对照组为9%，但超微结构缺陷与纤毛摆动频率之间的相关性较差。一名患者患有原发性纤毛运动障碍（PCD），有典型的临床病史且纤毛不动。然而，仅观察到继发性超微结构异常。我们未能证明纤毛超微结构缺陷是功能受损的基础。对于疑似PCD的患者，应取鼻刷检物进行功能和超微结构研究；理想情况下，应获取另一份样本以检查可能的原发性超微结构异常。
