本文關(guān)鍵詞：慢性硬化性涎腺炎的臨床病理分析及建立MDP誘導(dǎo)的慢性硬化性涎腺炎樣動(dòng)物模型　出處：《吉林大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： IgG4相關(guān)性疾病 涎腺炎 胞壁酰二肽 巨噬細(xì)胞 動(dòng)物模型

【摘要】：研究目的： 探討總結(jié)慢性硬化性涎腺炎（Chronic Sclerosing Sialadenitis, CSS）的臨床病理特征，并嘗試建立胞壁酰二肽（Muramyl Dipeptide, MDP）誘導(dǎo)的CSS樣動(dòng)物模型。 研究方法： 1.回顧性分析診斷2005年01月至2014年01月在吉林大學(xué)口腔醫(yī)院進(jìn)行治療的64例慢性涎腺炎患者，通過(guò)組織標(biāo)本的IgG及IgG4免疫組織化學(xué)染色，從中篩選出符合慢性硬化性涎腺炎13例，作為實(shí)驗(yàn)組，51例非特異性慢性涎腺炎作為對(duì)照組，并對(duì)兩組的臨床病理表現(xiàn)進(jìn)行回顧性對(duì)比分析以及CD68免疫組織化學(xué)染色分析； 2.應(yīng)用免疫佐劑與MDP混合注射入實(shí)驗(yàn)組大鼠右側(cè)的下頜下腺中，對(duì)照組大鼠的右側(cè)下頜下腺被注入免疫佐劑與PBS混合物，兩組均每周注射一次，分別注射4周、6周、8周后，取大鼠外周血進(jìn)行血常規(guī)分析及ELISA分析，并將大鼠灌流處死，取其雙側(cè)下頜下腺、腮腺及胰腺進(jìn)行組織固定包埋，切片進(jìn)行組織學(xué)分析。 研究結(jié)果： 1.兩組之間在年齡和性別上無(wú)顯著差異。CSS組：大部分患者均因無(wú)痛性單側(cè)或雙側(cè)涎腺腫物就診。4例患者存在涎腺以外器官受累（1例胰腺，3例淚腺），組織學(xué)以富含漿細(xì)胞及淋巴細(xì)胞浸潤(rùn)的纖維增生為主要特征，且其中11例可見(jiàn)擁有花形等不規(guī)則形狀生發(fā)中心的淋巴濾泡增生，大量CD68陽(yáng)性細(xì)胞彌漫性浸潤(rùn)。對(duì)照組：患者因涎腺反復(fù)腫痛就診，沒(méi)有患者存在涎腺以外器官受累，組織學(xué)表現(xiàn)為多種炎細(xì)胞浸潤(rùn)，，以及少或無(wú)細(xì)胞浸潤(rùn)的纖維增生。除一例外，其余病例中增生的淋巴濾泡中的生發(fā)中心均形態(tài)規(guī)則，部分病例可見(jiàn)CD68陽(yáng)性細(xì)胞浸潤(rùn)。 2.實(shí)驗(yàn)組與對(duì)照組的大鼠右側(cè)下頜下腺體積均增大。實(shí)驗(yàn)組大鼠4周后即出現(xiàn)外周血內(nèi)單核細(xì)胞百分比升高（與對(duì)照組相比P0.05），8周后更是明顯高于對(duì)照組（P0.01）；而8周后對(duì)照組大鼠外周血內(nèi)的淋巴細(xì)胞百分比則高于實(shí)驗(yàn)組（P0.05）。實(shí)驗(yàn)組大鼠8周后血清中IgG1濃度明顯高于對(duì)照組（P0.05），而對(duì)照組大鼠8周后的血清中IgG2b濃度高于實(shí)驗(yàn)組（P0.05）。從4周開(kāi)始，實(shí)驗(yàn)組大鼠雙側(cè)下頜下腺中可見(jiàn)纖維化增生及炎細(xì)胞浸潤(rùn)的表現(xiàn)。尤其是左側(cè)下頜下腺，與對(duì)照組相比出現(xiàn)更明顯的炎性改變。 研究結(jié)論： 1.CSS在臨床表現(xiàn)上與非特異性慢性涎腺炎差別不大，病理組織學(xué)上以淋巴細(xì)胞、漿細(xì)胞浸潤(rùn)和纖維化為主要特征，但診斷仍需借助IgG4及IgG的免疫組化染色。 2.巨噬細(xì)胞在CSS病理發(fā)展中具有一定的作用。 3.MDP免疫后的大鼠可出現(xiàn)類似于人CSS的臨床病理表現(xiàn)，MDP可能在CSS發(fā)病機(jī)制的初始階段扮演一定角色，可能與促進(jìn)單核巨噬細(xì)胞系統(tǒng)參與異常固有免疫應(yīng)答相關(guān)。通過(guò)MDP誘導(dǎo)可建立一種CSS樣動(dòng)物模型。
[Abstract]:The purpose of the study is:
Objective to summarize the clinicopathological features of Chronic Sclerosing Sialadenitis (CSS) and try to establish a CSS like animal model induced by Muramyl Dipeptide (MDP) two Muramyl.
Research methods:
1. a retrospective analysis of diagnosis of 64 cases of chronic sialadenitis patients treated in Stomatology Hospital of Jilin University from 2005 01 to 2014 01 months, by IgG and IgG4 immunohistochemical staining of tissue samples, were screened with chronic sclerosing sialadenitis in 13 cases, as the experimental group, 51 cases of nonspecific chronic sialadenitis as control group, and the clinical and pathological manifestations of the two groups were retrospectively analyzed and CD68 immunohistochemical analysis;
2. application of adjuvant mixed with MDP injection into the right experimental group rat submandibular gland in control group rat right mandibular gland was injected into the adjuvant mixture with PBS, two groups were injected once a week, were injected for 4 weeks, 6 weeks, 8 weeks later, the rats of peripheral blood. Blood routine analysis and ELISA analysis, and the rats were perfused, the submandibular gland, parotid gland and pancreas tissues were fixed and embedded, sliced for histological analysis.
The results of the study:
Between 1. and two groups in age and gender have no significant difference in group.CSS: most of the patients with painless unilateral or bilateral salivary gland tumor treatment.4 patients exist outside of salivary gland organ involvement (1 cases of pancreas, 3 cases of lacrimal gland), histological fibrosis in plasma cells and lymphocytes as the main feature, and 11 of them cases have visible flower shape irregular germinal center follicular hyperplasia, diffuse infiltration of a large number of CD68 positive cells. Control group: Patients with salivary gland swelling repeated treatment, no patients with salivary gland outside organ involvement, histological appearance for a variety of inflammatory cell infiltration, and little or no cell infiltration in fiber hyperplasia. One exception, the remaining cases of hyperplasia of lymphoid follicles in the germinal center of all morphological rules, some cases showed CD68 positive cell infiltration.
2. the experimental group and control group rat right mandibular gland volume increased. Experimental rats 4 weeks after emergence in peripheral blood mononuclear cells were significantly increased (compared with the control group, P0.05) after 8 weeks was significantly higher than the control group (P0.01); and the control group after 8 weeks of lymphocyte percentage the peripheral blood of rats in the experimental group was higher than that in serum (P0.05). After 8 weeks, the concentration of IgG1 in the rats of experimental group was significantly higher than the control group (P0.05), and control the concentration of IgG2b in serum after 8 weeks rats than in experimental group (P0.05). From the beginning of the 4 week, fibrosis and inflammatory hyperplasia the performance of cell infiltration in rats under the experimental mandibular gland. Especially in the left submandibular gland, compared with the control group had more obvious inflammatory changes.
The conclusions are as follows:
1.CSS has little difference in clinical manifestation with non-specific chronic sialositis. The main characteristics of lymphocytic, plasma cell infiltration and fibrosis are still in histopathology. However, IgG4 and IgG immunohistochemical staining is still needed for diagnosis.
2. macrophages have a certain role in the pathological development of CSS.
3.MDP immunized rats can appear similar to the clinical and pathological manifestations of CSS and MDP may play a role in the initial stage of CSS pathogenesis, and may promote the mononuclear macrophage system involved in innate immune responses induced by abnormal. We can establish a kind of animal model by CSS MDP.

【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R781.72

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