本文選題：牙髓炎 + 氧代謝��； 參考：《暨南大學(xué)》2015年碩士論文

【摘要】：背景及目的:牙髓炎是由細(xì)菌作為始動(dòng)因子引起牙髓組織的慢性感染性疾病。乏氧誘導(dǎo)因子-1(hypoxia inducible factor-1,HIF-1)作為細(xì)胞在乏氧情況下由激活基因編碼的轉(zhuǎn)錄因子。血管內(nèi)皮生長(zhǎng)因子(vascular endothelial growth factor,VEGF)是一種高度特異性的細(xì)胞因子,具有促進(jìn)血管內(nèi)皮細(xì)胞分裂、誘發(fā)血管形成及增加血管通透性的功能。在乏氧狀態(tài)下,HIF-1能夠誘導(dǎo)而轉(zhuǎn)錄激活VEGF,其作為HIF-1α的主要靶基因之一。目前研究發(fā)現(xiàn),HIF-1α和VEGF在腫瘤血管生成之間存在著密切關(guān)系。至今為止,HIF-1α和VEGF-c在牙髓炎中的作用研究甚少。本課題主要研究目的是觀察炎性牙髓組織中HIF-1α和VEGF-c表達(dá)與分布情況,分析牙髓組織在不同狀態(tài)下的缺氧情況及其程度。探討HIF-1α和VEGF-c調(diào)控牙髓組織炎癥進(jìn)程中的作用,研究結(jié)果將為闡明牙髓炎的氧代謝機(jī)制以及牙髓炎的靶向治療提供理論依據(jù)。方法:臨床隨機(jī)收集年齡在20~50歲之間患者的牙髓組織,其中男性18名,女性22名,平均年齡32.9±11.4歲。經(jīng)統(tǒng)計(jì)學(xué)處理分析各組之間在年齡、性別上差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),具有可比性。根據(jù)牙髓組織病理學(xué)分類(lèi)進(jìn)行如下四類(lèi)分組:正常牙髓組、深齲牙髓組、慢性牙髓炎組以及急性牙髓炎組共40例。所有牙髓標(biāo)本來(lái)自因正畸需要拔除或無(wú)法保留的第三磨牙。牙髓組織標(biāo)本于2%戊二醛溶液中固定48 h以上,制成頰舌向5μm厚度連續(xù)切片。通過(guò)HE染色方法,觀察各組牙髓標(biāo)本的組織學(xué)改變并評(píng)分;應(yīng)用免疫組織化學(xué)染色法,觀察HIF-1α和VEGF-c在人牙髓組織中的表達(dá)及分布、并計(jì)算陽(yáng)性細(xì)胞密度。應(yīng)用SPSS 16.0統(tǒng)計(jì)學(xué)軟件對(duì)所有數(shù)據(jù)進(jìn)行分析處理:1)用Kruskal-Wallis H秩和檢驗(yàn)比較不同組間牙髓組織炎癥程度評(píng)分;2)用Kruskal-Wallis H秩和檢驗(yàn)比較各組間牙髓HIF-1α和VEGF-c陽(yáng)性細(xì)胞密度;3)用Pearson相關(guān)分析,評(píng)估各組間牙髓炎癥程度評(píng)分與HIF-1α、VEGF-c陽(yáng)性細(xì)胞密度之間的相關(guān)性;4)通過(guò)Pearson相關(guān)分析,評(píng)估不同組間HIF-1α和VEGF-c表達(dá)水平之間的相關(guān)性。結(jié)果:1.牙髓組織學(xué)觀察結(jié)果1)正常牙髓組與深齲牙髓組中,無(wú)明顯炎性細(xì)胞浸潤(rùn)和炎性滲出物。2)與正常牙髓組相比,慢性牙髓炎組的牙髓組織出現(xiàn)中等程度的炎癥細(xì)胞浸潤(rùn)。3)與慢性牙髓炎組相比,急性牙髓炎組表現(xiàn)為更明顯的炎性細(xì)胞浸潤(rùn)。4)與正常牙髓組與深齲牙髓組相比,炎癥牙髓組織的炎癥程度評(píng)分顯著升高(P0.01)。其中,急性牙髓炎組的炎癥程度評(píng)分明顯高于慢性牙髓炎(P0.01)。2.牙髓組織中HIF-1α與VEGF-c免疫組化染色結(jié)果HIF-1α表達(dá)主要定位于成牙本質(zhì)細(xì)胞、成纖維細(xì)胞、血管內(nèi)皮細(xì)胞及部分炎癥細(xì)胞。正常牙髓組與深齲牙髓組中,牙髓組織幾乎沒(méi)有HIF-1α陽(yáng)性表達(dá)出現(xiàn)。與正常牙髓組與深齲牙髓組相比較,慢性牙髓炎組中HIF-1α陽(yáng)性細(xì)胞密度顯著升高(P0.01);且急性牙髓炎組HIF-1α陽(yáng)性細(xì)胞密度顯著高于慢性牙髓炎組(P0.01)。VEGF-c表達(dá)主要定位于成牙本質(zhì)細(xì)胞、成纖維細(xì)胞、血管內(nèi)皮細(xì)胞,巨噬細(xì)胞和漿細(xì)胞。正常牙髓組與深齲牙髓組中,牙髓組織見(jiàn)少量VEGF-c陽(yáng)性表達(dá)出現(xiàn)。與正常牙髓組與深齲牙髓組相比較,急性牙髓炎組中VEGF-c陽(yáng)性細(xì)胞密度顯著升高(P0.01);且慢性牙髓炎組VEGF-c陽(yáng)性細(xì)胞密度顯著高于急性牙髓炎組(P0.01)。3.HIF-1α和VEGF-c陽(yáng)性細(xì)胞密度與牙齦組織炎癥程度評(píng)分的相關(guān)性分析1)通過(guò)Pearson相關(guān)分析,不同組牙髓組織中HIF-1α陽(yáng)性細(xì)胞密度與炎癥程度評(píng)分存在正的直線相關(guān)關(guān)系(P0.01)。2)通過(guò)Pearson相關(guān)分析,不同組牙髓組織中VEGF-c陽(yáng)性細(xì)胞密度與炎癥程度評(píng)分存在正的直線相關(guān)關(guān)系(P0.01)。4.HIF-1α和VEGF-c表達(dá)水平的相關(guān)性分析經(jīng)Pearson相關(guān)分析,炎癥牙髓組織中HIF-1α陽(yáng)性細(xì)胞密度與VEGF-c陽(yáng)性細(xì)胞密度密切相關(guān),且存在正的直線相關(guān)關(guān)系(P0.01)。結(jié)論:1.與正常牙髓組、深齲牙髓組比較,炎癥的牙髓組織HIF-1α和VEGF-c的表達(dá)明顯升高。2.HIF-1α和VEGF-c的表達(dá)量與牙髓炎癥程度存在明顯的相關(guān)性。結(jié)果提示HIF-1α和VEGF-c可能參與牙髓炎的炎癥反應(yīng),其具體的作用機(jī)制仍需要進(jìn)一步的研究。
[Abstract]:Background and purpose: pulpitis is a chronic infectious disease of dental pulp tissue caused by bacteria as a starting factor. Hypoxia inducible factor -1 (hypoxia inducible factor-1, HIF-1) is a transcription factor encoded by activated genes in hypoxic conditions. Vascular endothelial growth factor (vascular endothelial growth factor, VEGF) is a kind of height. Specific cytokine has the function of promoting vascular endothelial cell division, inducing angiogenesis and increasing vascular permeability. In hypoxic state, HIF-1 can induce and transcriptional activation of VEGF, which is one of the main target genes of HIF-1 alpha. Current research has found that there is a close relationship between HIF-1 alpha and VEGF in tumor angiogenesis. So far, there is little research on the role of HIF-1 alpha and VEGF-c in pulpitis. The main purpose of this study is to observe the expression and distribution of HIF-1 alpha and VEGF-c in inflammatory pulp tissues, to analyze the condition of the anoxia and the extent of the dental pulp tissue in different states. The role of HIF-1 alpha and VEGF-c in the regulation of the inflammatory process of dental pulp tissue is discussed, and the results will be studied. To provide a theoretical basis for elucidating the oxygen metabolism mechanism of pulpitis and the targeting therapy of pulpitis. Methods: the dental pulp tissues of patients aged 20~50 were randomly collected, including 18 men and 22 women, with an average age of 32.9 + 11.4 years. There was no statistically significant difference in age between groups (P0.05) by statistical analysis. According to the pathological classification of dental pulp tissue, the following four groups of groups were divided: normal pulp group, deep caries pulp group, chronic pulpitis group and acute pulpitis group with 40 cases. All dental pulp specimens were extracted or unreserved third molar teeth. The dental pulp tissue was fixed in 2% glutaraldehyde solution more than 48 h, made of dental pulp tissue. The buccal tongue to 5 m thickness continuous slice. Through the HE staining method, the histological changes of the dental pulp specimens were observed and the scores were observed. The expression and distribution of HIF-1 alpha and VEGF-c in the human dental pulp tissues were observed and the density of the positive cells was calculated by immunohistochemical staining. All data were analyzed with the SPSS 16 system software: 1) K Ruskal-Wallis H rank sum test compared the degree of inflammation in dental pulp tissue between different groups; 2) the density of HIF-1 alpha and VEGF-c positive cells in dental pulp of each group was compared with Kruskal-Wallis H rank and test; 3) the correlation between the degree of inflammation of dental pulp and the density of HIF-1 A and VEGF-c positive cells was evaluated by Pearson correlation analysis; 4) through Pearson. Correlation analysis, evaluation of the correlation between HIF-1 alpha and VEGF-c expression levels between different groups. Results: 1. the results of dental pulp histology were 1) in the normal pulp group and the deep caries pulp group, there was no obvious inflammatory cell infiltration and inflammatory exudate.2) and the pulp tissue of the chronic pulpitis group had moderate inflammatory cell infiltration compared with the normal pulp group. 3) compared with the chronic pulpitis group, the acute pulpitis group showed a more obvious inflammatory cell infiltration.4). Compared with the normal dental pulp group and the deep caries pulp group, the inflammatory degree score of the inflammatory pulp tissue was significantly higher (P0.01). Among them, the severity score of the acute pulpitis group was significantly higher than that of the chronic pulpitis (P0.01).2. pulp tissue of HIF-1 a. The expression of HIF-1 alpha in VEGF-c immunohistochemical staining was mainly located in odontoblast, fibroblasts, vascular endothelial cells and some inflammatory cells. In the normal pulp group and the deep caries pulp group, there was almost no positive expression of HIF-1 alpha in the pulp tissue. Compared with the normal pulp group and the deep caries pulp group, the HIF-1 alpha in the chronic pulpitis group was in the group of the normal pulp and the deep caries pulp group. The density of positive cells increased significantly (P0.01), and the density of HIF-1 alpha positive cells in the acute pulpitis group was significantly higher than that in the chronic pulpitis group (P0.01). The expression of.VEGF-c was mainly located in odontoblasts, fibroblasts, vascular endothelial cells, macrophages and plasma cells. In the normal dental pulp group and the deep caries pulp group, a small amount of VEGF-c positive was found in the pulp tissue. Compared with the normal dental pulp group and the deep carious pulp group, the density of VEGF-c positive cells in the acute pulpitis group increased significantly (P0.01), and the density of VEGF-c positive cells in the chronic pulpitis group was significantly higher than that of the acute pulpitis group (P0.01), the correlation between the density of.3.HIF-1 alpha and VEGF-c positive cells and the grade of gingival tissue inflammation was 1). After Pearson correlation analysis, there was a positive linear correlation between the density of HIF-1 alpha positive cells in the dental pulp tissues and the degree of inflammation (P0.01).2 in different groups of dental pulp tissues. Through Pearson correlation analysis, there was a positive linear correlation between the density of VEGF-c positive cells in the dental pulp tissues and the degree of inflammation (P0.01).4.HIF-1 A and VEGF-c expression levels in different groups of dental pulp tissues. The correlation analysis was analyzed by Pearson correlation analysis. The density of HIF-1 alpha positive cells in inflammatory pulp tissues was closely related to the density of VEGF-c positive cells, and there was a positive linear correlation (P0.01). Conclusion: 1. the expression of HIF-1 alpha and VEGF-c in the pulp tissues of the normal dental pulp group and the deep carious pulp group increased the table of.2.HIF-1 A and VEGF-c. The results suggest that HIF-1 alpha and VEGF-c may be involved in the inflammatory response of pulpitis, and the specific mechanism of its action still needs further study.

【學(xué)位授予單位】：暨南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R781.31

【共引文獻(xiàn)】

相關(guān)期刊論文 前2條

1 王清妹;關(guān)為群;;牙髓中血管內(nèi)皮生長(zhǎng)因子的研究現(xiàn)狀[J];醫(yī)學(xué)綜述;2009年22期

2 劉高成;吳佩玲;步江;白新華;;正畸治療的年輕恒牙和成熟恒牙的牙髓組織中VEGF水平比較[J];新疆醫(yī)科大學(xué)學(xué)報(bào);2014年10期

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本文編號(hào)：1815698