本文選題：牙周炎　切入點：炎癥　出處：《大連醫(yī)科大學》2014年碩士論文

【摘要】：目的：牙周病是一種慢性感染性疾病，一系列的免疫炎癥反應(yīng)參與了疾病的病理過程。細胞因子在免疫應(yīng)答和炎癥反應(yīng)中發(fā)揮重要作用，趨化因子是細胞因子家族中的重要成員。CXCL16是一種新型的趨化因子，通過其受體CXCR6參與炎性細胞向病變組織的趨化。本實驗通過免疫組織化學法檢測趨化因子CXCL16及其受體CXCR6在中重度牙周炎齦組織和健康牙齦組織中的表達情況及其相互關(guān)系。 方法：收集遼寧省人民醫(yī)院口腔科門診就診和住院患者的牙齦組織，年齡控制在35～74周歲，將其分為兩組：健康牙齦組（40例）、中重度牙周炎組（39例）。 健康牙齦組納入標準：牙齒清潔，無齲洞，無疼痛感；牙齦顏色正常，無自發(fā)性或探診出血。中重度牙周炎組入選標準參照第四版《牙周病學》。 排除標準：有其他全身系統(tǒng)性疾病及藥物過敏史；3個月內(nèi)曾使用抗生素、腎上腺皮質(zhì)激素、非甾體類抗炎藥、性激素及避孕藥等；6個月內(nèi)有心梗發(fā)生；吸煙史。 按照免疫組織化學染色法制片，光學生物顯微鏡下觀察牙齦組織中CXCL16和CXCR6的分布和細胞定位，用免疫組織化學半定量分析(傳統(tǒng)人工計數(shù))法對數(shù)據(jù)進行綜合評估，并使用SPSS15.0軟件包對數(shù)據(jù)進行統(tǒng)計學分析。 結(jié)果：1. CXCL16及CXCR6在中重度牙周炎患者的牙齦組織中均有表達。CXCL16主要表達在結(jié)締組織區(qū)牙齦成纖維細胞、淋巴細胞（漿細胞）和血管內(nèi)皮細胞的細胞膜及細胞質(zhì)中，染色呈淡黃色至棕褐色；CXCR6主要表達在結(jié)締組織區(qū)牙齦成纖維細胞、淋巴細胞（漿細胞）和血管內(nèi)皮細胞的細胞膜上，染色呈淡黃色至棕褐色。 2. CXCL16在健康牙齦組織中無染色或散在淡黃色顆粒狀染色，CXCR6在正常牙齦組織中未見或偶見淡黃色顆粒狀染色。 3. CXCLl6在牙周炎齦組織、健康牙齦組織中的陽性表達率分別是92.31%、40.00%，，在牙周炎中以陽性表達為主，在健康牙齦組織中則低表達或無表達。中重度牙周炎組與健康牙齦組比較，CXCL16表達顯著性升高，差異具有統(tǒng)計學意義(P0.05)。 4. CXCR6在牙周炎齦組織、健康牙齦組織中的陽性表達率分別是100%、30.00%；中重度牙周炎組與健康牙齦組比較，CXCR6表達顯著性升高，差異具有統(tǒng)計學意義(P0.05)。 5．經(jīng)相關(guān)性分析，CXCLl6與CXCR6在中重度牙周炎患者牙齦組織中的表達呈正相關(guān)(r=0.580，P0.05)，有統(tǒng)計學意義；而在健康牙齦組織中，二者的表達不相關(guān)。 結(jié)論：1.趨化因子CXCLl6及其受體CXCR6在中重度牙周炎組中的表達高于健康牙齦組，提示CXCLl6、CXCR6可能與牙周炎的發(fā)病有關(guān)。 2．CXCLl6和CXCR6在中重度牙周炎齦組織中的表達呈正相關(guān)，提示二者在牙周炎的發(fā)病過程中可能共同發(fā)揮作用。
[Abstract]:Objective : To investigate the expression of chemokine CXCL16 and its receptor on the gingival tissues and healthy gingival tissues of moderate and severe periodontitis by immunohistochemical method . CXCL16 plays an important role in immune response and inflammatory response .

Methods : The gingival tissues of the outpatient department and the hospitalized patients were collected from the Department of Stomatology of the People ' s Hospital of Liaoning Province . The age was controlled between 35 and 74 years , and the patients were divided into two groups : healthy gum group ( 40 cases ) and moderate and severe periodontitis group ( 39 cases ) .

Healthy gingival group included standard : tooth cleaning , no caries hole , no pain feeling ;
The gingival color is normal without spontaneous or diagnostic bleeding . The criteria for inclusion in the moderate and severe periodontitis group are referred to in the 4th edition of the periodontal disease group .

Exclusion criteria : there are other systemic diseases and drug allergies ;
antibiotics , adrenocorticoids , non - steroidal anti - inflammatory drugs , sex hormones and contraceptives have been used within 3 months ;
myocardial infarction occurred within 6 months ;
History of smoking .

According to the immunohistochemical staining method , the distribution and cell localization of CXCL16 and CXCR4 6 in gingival tissues were observed under the optical biological microscope . The data were comprehensively evaluated by semi - quantitative analysis ( traditional manual counting ) method , and the data were analyzed statistically by SPSS 15.0 .

Results : 1 . CXCL16 was expressed in gingival fibroblasts , lymphocytes ( plasma cells ) and vascular endothelial cells of connective tissue . CXCL16 was mainly expressed in gingival fibroblasts , lymphocytes ( plasma cells ) and vascular endothelial cells .
On the cell membranes of gingival fibroblasts , lymphocytes ( plasma cells ) and vascular endothelial cells in connective tissue , the staining was pale yellow to tan .

2 . The CXCL16 did not stain or disperse in pale yellow granular staining in healthy gum tissue .

3 . The positive expression rates of CXCLl6 in gingival tissues and healthy gums were 92.31 % and 40.00 % , respectively .

4 . The positive expression rates were 100 % and 30.00 % in the gingival tissues of periodontitis and healthy gum tissues , respectively .
Compared with the healthy gum group in moderate and severe periodontitis group , there was a statistically significant difference in the expression of IL 6 in the patients with moderate and severe periodontitis ( P0.05 ) .

5 . The correlation analysis showed that CXCLl6 had positive correlation between CXCLl6 ( r = 0.580 and P0.05 ) in the gingival tissues of patients with moderate and severe periodontitis ( r = 0.580 , P0.05 ) .
In healthy gum tissue , the expression of the two is not related .

Conclusion : 1 . The expression of chemokine CXCLl6 and its receptor in moderate and severe periodontitis group is higher than that of healthy gum group , and suggests CXCLl6 and CXCLl6 may be related to the pathogenesis of periodontitis .

2 . The expression of CXCLl6 and CD6 in gingival tissues of moderate and severe periodontitis was positively correlated , suggesting that both might play a role in the pathogenesis of periodontitis .

【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R781.42

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