【摘要】：目的 1、非特異性輸尿管炎的臨床報(bào)道較少,本文通過(guò)對(duì)30例非特異性輸尿管炎臨床相關(guān)資料的回顧性分析,探討非特異性輸尿管炎的臨床特點(diǎn)與診斷治療要點(diǎn)。 2、非特異性輸尿管炎的病因機(jī)制迄今不清,本文通過(guò)檢測(cè)多種炎癥因子在非特異性輸尿管炎的表達(dá)情況,探討炎癥因子在非特異性輸尿管炎發(fā)病機(jī)制中的作用。 材料與方法 收集天津醫(yī)科大學(xué)第二醫(yī)院、天津醫(yī)科大學(xué)靜海臨床學(xué)院臨床資料完整、行手術(shù)切除、病理證實(shí)的非特異性輸尿管炎病理標(biāo)本30例,收集10例腎癌根治術(shù)及腎盂癌根治術(shù)的輸尿管標(biāo)本做對(duì)照。兩組性別、年齡、輸尿管取材部位相匹配。 1、對(duì)30例非特異性輸尿管炎患者的臨床資料進(jìn)行回顧性分析,總結(jié)特異性輸尿管炎的臨床特點(diǎn)。 2、采用免疫組化法檢測(cè)輸尿管粘膜標(biāo)本中TGF-β、IL-1、IL-6、IL-8、IL-17、IL-23的表達(dá)情況。運(yùn)用圖像分析技術(shù)計(jì)數(shù)切片中陽(yáng)性細(xì)胞數(shù),取光學(xué)顯微鏡下高倍視野(×400)陽(yáng)性細(xì)胞表達(dá)強(qiáng)度作為計(jì)數(shù)標(biāo)準(zhǔn)。計(jì)量資料應(yīng)用t檢驗(yàn)分析,計(jì)數(shù)資料應(yīng)用x2檢驗(yàn)和分類(lèi)變量的等級(jí)相關(guān)分析,P0.05認(rèn)為有統(tǒng)計(jì)學(xué)差異。 結(jié)果 1、非特異性輸尿管炎是一種病因不十分清楚的節(jié)段性非特異性輸尿管炎癥,好發(fā)于輸尿管中下段,上段相對(duì)少見(jiàn),以女性下尿路易感人群為多見(jiàn)。病理特點(diǎn)為輸尿管管壁呈現(xiàn)不同程度的炎性細(xì)胞浸潤(rùn)。該病缺乏特異性臨床表現(xiàn),影像學(xué)及輸尿管鏡檢查為主要確診手段。治療應(yīng)該根據(jù)患側(cè)腎功能狀況以及輸尿管病變的程度、部位和范圍而確定。 2、在非特異性輸尿管炎和對(duì)照組輸尿管中TGF-β、IL-1、IL-6、IL-8、IL-17、IL-23的表達(dá)有統(tǒng)計(jì)學(xué)差異(P0.05),在非特異性輸尿管炎中表達(dá)強(qiáng)度高于對(duì)照組輸尿管。 結(jié)論 1、非特異性輸尿管炎臨床表現(xiàn)缺乏特異性,診斷主要根據(jù)影像學(xué)及病理特點(diǎn),治療目的為解除輸尿管梗阻和保護(hù)腎功能。 2、非特異性輸尿管炎TGF-β、IL-1、IL-6、IL-8、IL-17、IL-23的表達(dá)強(qiáng)度明顯高于對(duì)照組輸尿管,提示以上六種細(xì)胞因子在非特異性輸尿管炎疾病的發(fā)生、發(fā)展中具有重要的作用。為今后非特異性輸尿管炎疾病的病因?qū)W研究提供了理論基礎(chǔ),同時(shí)開(kāi)辟了以細(xì)胞因子為切入點(diǎn)治療非特異性輸尿管炎疾病的新途徑。
[Abstract]:Objective 1. There are few clinical reports on nonspecific ureteritis. The clinical features and diagnosis and treatment of nonspecific ureteritis were discussed by retrospective analysis of 30 cases of nonspecific ureteritis. 2. The etiological mechanism of nonspecific ureteritis is unclear. The expression of various inflammatory factors in nonspecific ureteritis was detected to explore the role of inflammatory factors in the pathogenesis of nonspecific ureteritis. Materials and methods 30 cases of nonspecific ureteritis were collected from the second Hospital of Tianjin Medical University and Jinghai Hospital of Tianjin Medical University. The ureteral specimens of 10 cases of radical renal carcinoma and radical resection of renal pelvis carcinoma were collected and compared. The sex, age and site of ureter were matched. 1. The clinical data of 30 patients with nonspecific ureteritis were retrospectively analyzed and the clinical features of specific ureteritis were summarized. 2. Immunohistochemical method was used to detect the expression of TGF- 尾 and IL-1,IL-6,IL-8,IL-17,IL-23 in ureteral mucosa. The number of positive cells in sections was counted by image analysis technique, and the intensity of positive cells in high power field of vision (脳 400) under optical microscope was taken as the counting standard. The measurement data were analyzed by t test, the count data by x2 test and the rank correlation analysis of classified variables. Results 1. Nonspecific ureteritis is a segmental nonspecific ureteritis with unclear etiology. It is more common in the middle and lower ureteral segment than in the upper ureteral segment, especially in the female lower urinary tract susceptible population. Pathological features of the ureteral wall showed different degrees of inflammatory cell infiltration. Lack of specific clinical manifestations, imaging and ureteroscopy as the main means of diagnosis. Treatment should be determined according to the renal function of the affected side and the extent, location and extent of ureteral lesions. (2) the expression of TGF- 尾 and IL-1,IL-6,IL-8,IL-17,IL-23 in ureter of nonspecific ureteritis was significantly different from that in control group (P0.05). In nonspecific ureteritis, the expression level was higher than that in the control group. Conclusion 1. The clinical manifestation of nonspecific ureteritis is lack of specificity. The diagnosis is mainly based on the imaging and pathological features. The purpose of treatment is to relieve ureteral obstruction and protect renal function. 2. The expression of TGF- 尾 and IL-1,IL-6,IL-8,IL-17,IL-23 in nonspecific ureteritis was significantly higher than that in control group, suggesting that the above six cytokines might occur in nonspecific ureteritis. Development plays an important role. It provides a theoretical basis for the etiological study of nonspecific ureteritis in the future and opens up a new approach to treat nonspecific ureteritis disease with cytokines as the cut-in point.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R693.3

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