本文選題：川崎病　切入點：冠脈損害　出處：《川北醫(yī)學(xué)院》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：第一部分Ang-Ⅱ、p22phox與川崎病及其冠脈損害相關(guān)性的研究目的:探索Ang-Ⅱ、p22phox二者在川崎病及冠脈損害中的作用。方法:1.酶聯(lián)免疫吸附實驗(enzyme-linked immunosorbent assay,ELISA)檢測51(15例冠脈損害,36例冠脈正常)例川崎病患兒及28名正常體檢兒童血漿Ang-Ⅱ。2.實施熒光定量聚合酶鏈反應(yīng)法(real-time polymerase chain reaction,RT-PCR)檢測40例川崎病患兒(15例冠脈損害,25例冠脈正常)和20名正�；純后w檢外周血單個核細(xì)胞p22phox m RNA表達(dá)。結(jié)果:1.川崎病血漿Ang-Ⅱ濃度冠脈損害組(Coronary artery lesions,CALs)與無冠脈損害組(Non Coronary artery lesions,NCALs)表達(dá)無明顯差異(P0.05),CALs及NCALs均顯著高于正常組(P0.01)。2.川崎病外周血單個核細(xì)胞p22phox m RNA表達(dá)水平CALs與無冠脈損害組NCALs表達(dá)無明顯差異(P0.05),CALs與NCALs均高于正常組(P0.05)。3.川崎病外周血單個核細(xì)胞p22phox m RNA表達(dá)水平與血漿Ang-Ⅱ濃度呈正相關(guān)關(guān)系(r=0.358,P=0.023)。結(jié)論:Ang-Ⅱ、p22phox可能參與了川崎病的發(fā)病機(jī)制,是否在川崎病冠脈損害中起作用有待進(jìn)一步研究。第二部分靜脈用丙種球蛋白治療對川崎病Ang-Ⅱ及p22phoxm RNA表達(dá)的影響目的:探索靜脈丙種球蛋白(intravenous immunoglobulin,IVIG)治療的作用機(jī)制,以及IVIG治療對川崎病Ang-Ⅱ及p22phox m RNA表達(dá)的影響。方法:1.ELISA檢測51例川崎病患兒治療前、治療后及28名健康兒童血漿Ang-Ⅱ濃度。2.RT-PCR檢測40例川崎病患兒IVIG治療前、治療后(15例冠脈損害和25例無冠脈損害)及20名健康兒童外周血單個核細(xì)胞p22phox m RNA表達(dá)水平。結(jié)果:1.患兒血漿Ang-Ⅱ濃度,治療前明顯高于治療后及正常組(P0.01),治療后明顯高于正常組(P0.01)。2.川崎病患兒外周血單個核細(xì)胞p22phox m RNA表達(dá)水平治療前高于治療后(P0.05),明顯高于正常組(P0.01),治療后與正常組比較無明顯差異(P0.05)。結(jié)論:IVIG治療對Ang-Ⅱ及p22phox m RNA表達(dá)在急性期均有影響。第三部分川崎病患兒血清對體外培養(yǎng)的血管內(nèi)皮細(xì)胞的損傷作用目的:探討川崎病患兒治療前后血清干預(yù)對體外培養(yǎng)的血管內(nèi)皮細(xì)胞的作用及臨床意義方法:1.分別以川崎病患兒治療前、治療后和健康兒童血清(體積分?jǐn)?shù)均為10%)處理人臍靜脈內(nèi)皮細(xì)胞(HUVEC)(川崎病患兒治療前、后血清組n=36;健康兒童血清組n=19)24小時。2.倒置相差顯微鏡觀察細(xì)胞形態(tài);3.流式細(xì)胞術(shù)檢測細(xì)胞凋亡率;4.酶聯(lián)免疫ELISA法檢測10例患兒培養(yǎng)細(xì)胞上清液中血管緊張素Ⅱ(AngⅡ)的質(zhì)量濃度;5.Real-Time PCR檢測內(nèi)皮細(xì)胞p22phox m RNA表達(dá)。結(jié)果:1.與健康血清組和空白對照組比較,治療前及治療后血清組HUVEC的細(xì)胞數(shù)量明顯減少,細(xì)胞核固縮、邊緣化,胞質(zhì)濃縮。2.治療前血清組細(xì)胞凋亡率為(17.48±1.14)%,治療后血清組細(xì)胞凋亡率為(8.33±0.79)%,健康血清組細(xì)胞凋亡率為(6.09±0.45)%,空白對照組細(xì)胞凋亡率為(4.22±0.39)%。3.治療前、后血清組細(xì)胞培養(yǎng)上清中AngⅡ的質(zhì)量濃度無明顯差異(P0.05)。4.與治療后血清組及健康血清組比較,治療前血清組p22phox m RNA表達(dá)增高(P0.01),治療后血清組與正常組表達(dá)無明顯差異(P0.05)。結(jié)論:川崎病患兒治療前血清干預(yù)使HUVEC細(xì)胞形態(tài)發(fā)生改變,抑制細(xì)胞增殖并促進(jìn)細(xì)胞凋亡,p22phoxm RNA表達(dá)增高可能導(dǎo)致內(nèi)皮細(xì)胞功能受損。
[Abstract]:The first part of Ang-, p22phox and Kawasaki disease and coronary artery lesion Objective: To explore the correlation between Ang- II and p22phox two role in disease and coronary artery lesion in Kawasaki. Methods: 1. enzyme-linked immunosorbent assay (enzyme-linked immunosorbent, assay, ELISA) was detected in 51 (15 cases of coronary artery lesion, 36 cases with normal coronary arteries) with Kawasaki sick children and 28 normal children on plasma Ang-.2. fluorescence quantitative polymerase chain reaction (real-time polymerase chain reaction, RT-PCR) were detected in 40 patients (Kawasaki 15 cases of coronary artery damage, 25 cases of normal coronary artery) and expression of p22phox in mononuclear cells of M RNA blood of 20 normal children peripheral examination. Results: 1. Kawasaki disease plasma Ang- II coronary artery lesion group (Coronary artery lesions, CALs) and non coronary artery lesion group (Non Coronary, artery lesions, NCALs) showed no significant difference (P0.05), CALs and NCALs were significantly higher than normal group (P 0.01) Kawasaki.2. disease p22phox in peripheral blood mononuclear cells m RNA expression level of CALs and coronary artery lesion group NCALs showed no significant difference (P0.05), CALs and NCALs were higher than the normal group (P0.05).3. Kawasaki disease p22phox in peripheral blood mononuclear cells m RNA expression level correlated with plasma Ang- II concentration was positively related (r=0.358, P=0.023). Conclusion: Ang- II, p22phox may be involved in pathogenesis of the disease is in Kawasaki, Kawasaki plays a role in coronary artery lesion disease needs further study. The second part of intravenous immunoglobulin therapy effect on the expression of Kawasaki Ang- II and p22phoxm disease RNA Objective: To explore the intravenous immunoglobulin (intravenous immunoglobulin. IVIG) the mechanism of therapeutic effect, and the effect of IVIG treatment on the expression of Kawasaki Ang- II and p22phox m RNA disease. Methods: with Kawasaki 1.ELISA detection in the treatment of 51 cases of disease before and after treatment and 28 healthy children on plasma Ang- concentration Kawasaki.2.RT-PCR IVIG disease detection treatment in 40 cases before and after treatment (15 cases of coronary artery lesion and 25 cases without coronary artery lesions) the level of p22phox in peripheral blood mononuclear cells m expression of RNA and 20 healthy children. Results: 1. patients with plasma Ang- II concentration before treatment was significantly higher than that after treatment and the normal control group (P0.01), after treatment was significantly higher than the normal group (P0.01) p22phox in peripheral blood mononuclear cells m RNA expression of.2. in children with Kawasaki disease levels before treatment than after treatment (P0.05), significantly higher than the normal group (P0.01), after treatment and control group had no significant difference (P0.05). Conclusion: the expression of IVIG in acute treatment effect all the stages of Ang- II and p22phox m RNA. The third part Kawasaki injury disease serum on cultured vascular endothelial cells Objective: To investigate the serum before and after treatment in children with Kawasaki disease intervention on vascular endothelial cells cultured in vitro and its clinical significance 1. respectively in the treatment of children with Kawasaki disease before after treatment and serum of healthy children (volume 10%) treated human umbilical vein endothelial cells (HUVEC) (treated with Kawasaki before disease, serum n=36 group; serum n=19 healthy children group) 24 hours.2. inverted microscope to observe cell morphology; cell apoptosis was detected in 3. flow cytometry detection rate; 4. enzyme-linked immunosorbent ELISA method in 10 cases of vascular cell culture supernatant of angiotensin II (Ang II) mass concentration; the expression of 5.Real-Time PCR p22phox m RNA to detect endothelial cells. Results: 1. with healthy serum group and blank control group, the number of HUVEC cells decreased significantly in serum group before and after treatment, nuclear condensation, marginalization, cytoplasm condensed.2. before treatment serum cell apoptosis rate was (17.48 + 1.14)% after treatment, serum cell apoptosis rate was (8.33 + 0.79)%, healthy blood group apoptosis rate was (6.09 + 0.45)%, Blank control group apoptosis rate was (4.22 + 0.39)%.3. before treatment, serum concentration of Ang II cells in the supernatant had no significant difference (P0.05) after the treatment with.4. serum group and healthy serum group, before treatment serum p22phox m increased expression of RNA (P0.01) after treatment, serum and the normal group showed no significant difference (P0.05). Conclusion: children with Kawasaki disease before treatment serum HUVEC changes in cell morphology, inhibit cell proliferation and promote cell apoptosis, p22phoxm expression of RNA may lead to endothelial cell dysfunction.

【學(xué)位授予單位】：川北醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R725.4

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