本文選題：唇裂 + 瘢痕�。� 參考：《青島大學(xué)》2017年碩士論文

【摘要】：目的:通過對(duì)MMP-1、TIMP-1在唇裂術(shù)后上唇皮膚增生性瘢痕組織和扁平性瘢痕組織中的表達(dá)進(jìn)行檢測(cè)研究,探討兩者在唇裂術(shù)后不同瘢痕組織中表達(dá)的異同,進(jìn)一步探索瘢痕形成機(jī)制,為唇裂修復(fù)術(shù)后減少上唇瘢痕組織的形成提供理論依據(jù)。方法:收集2015年11月至2017年1月于青島市海慈醫(yī)療集團(tuán)在口腔頜面外科單側(cè)Ⅲ度唇裂修復(fù)術(shù)后畸形要求二次修復(fù)治療的患者及上唇部外傷后的患者,取唇裂修復(fù)術(shù)術(shù)后二次修復(fù)中的上唇增生性瘢痕組織標(biāo)本22例,扁平性瘢痕組織18例,唇部外傷需要整修所遺棄的正常皮膚皮下組織標(biāo)本15例.通過HE染色觀察唇裂術(shù)后上唇增生性瘢痕組織及扁平性瘢痕組織中成纖維細(xì)胞的形態(tài)、膠原排列情況;通過免疫組化染色觀察各組標(biāo)本中MMP-1、TIMP-1的表達(dá)程度;用專業(yè)圖片處理軟件Image-Pro Plus來(lái)測(cè)量每個(gè)視野區(qū)的累計(jì)光密度(IOD)和區(qū)域面積,平均光密度(AOD)是IOD/區(qū)域面積,AOD值作為MMP-1和TIMP-1的蛋白含量指標(biāo),對(duì)所得數(shù)據(jù)進(jìn)行處理,取每組AOD的平均值;利用SPSS20.0對(duì)所得數(shù)據(jù)進(jìn)行處理分析,取每組AOD的平均,采用單因素多組獨(dú)立樣本LSD-t檢驗(yàn),比較三組標(biāo)本中MMP-1、TIMP-1的蛋白含量間差異,比較三組標(biāo)本之間的MMP-1和TIMP-1的含量,判斷各組標(biāo)本MMP-1和TIMP-1含量之間是否存在有統(tǒng)計(jì)學(xué)意義的差異。結(jié)果:1.組織學(xué)上觀察:(1)扁平性瘢痕組織:表皮的角質(zhì)細(xì)胞層較厚,可見汗腺,毛囊等皮膚附屬器,真皮層有增生的結(jié)締組織,膠原排列較規(guī)則,少量炎細(xì)胞存在。(2)增生性瘢痕組織:表皮的角質(zhì)細(xì)胞層增厚,乳頭層近乎消失,真皮層中有增生的纖維結(jié)締組織,粗大的膠原且排列紊亂,其間有增多的毛細(xì)血管;2.在上唇部正常皮膚組、扁平性瘢痕組、增生性瘢痕組中MMP-1的含量分別為0.023657±0.008477,0.040395±0.011534,0.097905±0.020593,上唇部增生性瘢痕組在三組標(biāo)本中MMP-1的含量最高,上唇正常皮膚組中MMP-1的含量最低,三組之間兩兩比較P0.05,各組間MMP-1含量比較均具有統(tǒng)計(jì)學(xué)意義;3.在上唇部正常皮膚組、扁平性瘢痕組、增生性瘢痕組中TIMP-1的含量分別0.024574±0.009210,0.053827±0.015087,0.157606±0.031090,上唇部增生性瘢痕組在三組標(biāo)本中MMP-1的含量最高,正常皮膚組中含量最低,三者之間兩兩比較P0.05,各組間比較在統(tǒng)計(jì)學(xué)上具有差異。結(jié)論:1.在組織結(jié)構(gòu)上,唇裂術(shù)后,上唇皮膚增生性與扁平性性瘢痕組織在膠原數(shù)量及排列存在差異,兩者與正常皮膚在皮膚附屬器、膠原數(shù)量及排列均存在差異。2.上唇部皮膚瘢痕的形成可能受MMP-1、TIMP-1的重要調(diào)節(jié)作用;3.MMP-1、TIMP-1在唇裂術(shù)后扁平性瘢痕和增生性瘢痕中表達(dá)的變化可能是形成引起皮膚瘢痕程度不同的原因之一。
[Abstract]:Objective: to study the expression of MMP-1 and TIMP-1 in hypertrophic scar tissue and flat scar tissue of upper lip after cleft lip surgery, and to explore the differences and similarities of the expression of MMP-1 and TIMP-1 in different scar tissues after cleft lip surgery, and to explore the mechanism of scar formation.To provide a theoretical basis for the reduction of scar formation in upper lip after cleft lip repair.Methods: from November 2015 to January 2017, patients with secondary repair of deformity after unilateral third degree cleft lip repair of oral and maxillofacial surgery and patients with upper lip trauma in Qingdao Haitsi Medical Group were collected.22 cases of hypertrophic scar tissue of upper lip, 18 cases of flat scar tissue and 15 cases of normal skin tissue in need of repair after secondary repair of cleft lip were obtained.The morphology and collagen arrangement of fibroblasts in hypertrophic scar tissue and flat scar tissue of upper lip after cleft lip were observed by HE staining, and the expression of MMP-1 and TIMP-1 was observed by immunohistochemical staining.The cumulative optical density (IOD) and the area area of each visual field were measured by the professional image processing software Image-Pro Plus. The average optical density (AODD) was used as the protein content index of MMP-1 and TIMP-1, and the average optical density (AODD) was used as the protein content index of MMP-1 and TIMP-1.The average value of AOD in each group was analyzed by SPSS20.0, and the average value of AOD in each group was analyzed. The protein content of MMP-1 and TIMP-1 was compared between the three groups by LSD-t test of single factor and multiple groups of independent samples.The contents of MMP-1 and TIMP-1 were compared among the three groups, and the difference between MMP-1 and TIMP-1 in each group was statistically significant.The result is 1: 1.Histologically, the flat scar tissue: the keratinocyte layer of the epidermis is thicker, there are sweat glands, hair follicles and other skin appendages, the dermis has proliferating connective tissue, and the collagenous arrangement is more regular.A small number of inflammatory cells exist in hypertrophic scar tissue: the keratinocyte layer of the epidermis is thickened, the papillary layer is almost disappeared, there is proliferative fibrous connective tissue in the dermis, the collagen is coarse and arranged disorderly, and there are increased capillaries 2.The content of MMP-1 in normal skin group, flat scar group and hypertrophic scar group were 0.023657 鹵0.008477 鹵0.040395 鹵0.011534 鹵0.097905 鹵0.020593.The MMP-1 content in the upper lip hypertrophic scar group was the highest in the three groups, and the MMP-1 content in the normal upper lip skin group was the lowest.There were significant differences in MMP-1 content among the three groups (P 0.05).The content of TIMP-1 in normal skin group, flat scar group and hypertrophic scar group were 0.024574 鹵0.00921010, 0.053827 鹵0.015087, 0.157606 鹵0.031090, respectively. The content of MMP-1 was the highest in the upper lip hypertrophic scar group and the lowest in the normal skin group.There were statistical differences among the three groups (P 0.05).Conclusion 1.There were differences in the number and arrangement of collagen between hyperplastic and flattened scar tissues of upper lip after cleft lip surgery, and there were differences between them in the number and arrangement of collagen in skin appendages and normal skin.The formation of scar in upper lip may be regulated by MMP-1 and TIMP-1. 3. The changes of TIMP-1 expression in flat scar and hypertrophic scar after cleft lip may be one of the reasons for the different degree of skin scar.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R782.2

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