本文選題：復發(fā)性阿弗他潰瘍　切入點：胰島素抵抗　出處：《山西醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:本研究通過檢測復發(fā)性阿弗他潰瘍(Recurrent aphthous ulcers,RAU)伴肥胖(Obese,OB)患者、單純RAU或OB患者與健康人的血清胰島素抵抗(Insulin resistance,IR)情況及腫瘤壞死因子-α(Tumor necrosis factor-α,TNF-α)的表達水平,分析RAU對肥胖個體IR情況的影響及與TNF-α的相關性,為指導RAU患者進行IR的早期篩查、診斷和干預,以預防前期糖尿病的發(fā)生并延緩其向糖尿病的轉化提供參考依據。方法:本研究隨機選擇了于2015年11月至2016年12月在山西醫(yī)科大學第一醫(yī)院口腔科門診就診并被確診為輕型RAU的40例患者,根據身體質量指數分為RAU伴肥胖組(20例)和RAU組(20例);并選擇同期就診于山西醫(yī)科大學第一醫(yī)院體檢中心既往無RAU病史的40例志愿者,根據身體質量指數分為肥胖組(20例)和對照組(20例)。四組分別應用美國貝克曼庫爾特公司生產的AU5821系列全自動生化分析儀使用已糖激酶法檢測血清中空腹血糖含量,中國科大創(chuàng)新有限公司生產的GC-1200γ放射免疫計數器使用放射免疫法檢測血清中空腹胰島素含量,并通過公式計算得出胰島素抵抗指數HOMA-IR分值,采用美國分子儀器公司生產的連續(xù)波長酶標儀使用酶聯免疫吸附法(ELISA)檢測血清中TNF-α含量。由同一名口腔科醫(yī)師對患者進行口腔黏膜檢查并記錄RAU發(fā)作的部位、大小及數目。收集并記錄四組個人資料包括年齡,性別,身高,體重及既往病史以及檢測、計算所得數據。采用SPSS22.0統(tǒng)計分析軟件根據實驗數據行統(tǒng)計學分析,并認為P0.05時結果有統(tǒng)計學差異。結果:1.TNF-α含量RAU+OB組高于RAU組和OB組(P0.05,P0.05);RAU組和OB組高于對照組(P0.05,P0.05)。RAU與OB均可作為主效應影響TNF-α含量(P0.05,P0.05),且兩者具有相互協同作用(P0.05)。2.空腹血糖濃度RAU+OB組高于RAU組(P0.05);RAU+OB組高于OB組(P0.05);RAU組和OB組高于對照組(P0.05,P0.05);RAU可作為主效應影響血糖濃度(P0.05),OB對血糖濃度無明顯影響(P0.05),兩者無明顯交互作用(P0.05)。3.空腹胰島素濃度RAU+OB組高于RAU組和OB組(P0.05,P0.05);RAU組和OB組高于對照組(P0.05,P0.05)。RAU與OB均可作為主效應影響胰島素濃度(P0.05,P0.05),但兩者無明顯交互作用(P0.05)。4.HOMA-IR值RAU+OB組高于RAU組和OB組(P0.05,P0.05);RAU組和OB組高于對照組(P0.05,P0.05)。RAU與OB均可作為主效應影響HOMA-IR值(P0.05,P0.05),但兩者無明顯交互作用(P0.05)。5.相關性分析顯示,血清TNF-α含量與HOMA-IR分值呈正相關性(P0.05)。結論:1.RAU患者處于活動期時可能存在機體血清TNF-α、IR表達水平升高的現象,在肥胖個體更加明顯。2.RAU患者處于活動期時可能存在機體血清空腹血糖濃度升高的現象。3.血清TNF-α表達水平與胰島素抵抗指數呈正相關。
[Abstract]:Objective: to investigate the serum insulin resistance of patients with recurrent aphthous ulcersrau (Rau), simple RAU or OB and healthy subjects, and the expression of tumor necrosis factor- 偽 Tumor necrosis factor- 偽 (TNF- 偽). To analyze the influence of RAU on IR in obese individuals and its correlation with TNF- 偽, to guide the early screening, diagnosis and intervention of IR in RAU patients. Methods: in order to prevent the occurrence of prediabetes mellitus and delay its transformation into diabetes mellitus. Methods: this study randomly selected from November 2015 to December 2016 in the Department of Stomatology of the first Hospital of Shanxi Medical University, and was treated by the Department of Stomatology. 40 patients diagnosed as mild RAU, According to body mass index (BMI), 20 cases of RAU with obesity) and 20 cases of RAU group were divided into two groups, and 40 volunteers who had no history of RAU in the physical examination Center of the first Hospital of Shanxi Medical University were selected at the same time. According to body mass index (BMI), 20 patients were divided into obese group (n = 20) and control group (n = 20). AU5821 series automatic biochemical analyzer produced by Beckman Kurt Company of USA was used to detect fasting blood glucose in serum by hexokinase method. The GC-1200 緯 RIA counter produced by China University of Science and Technology Innovation Co., Ltd. uses radioimmunoassay to detect fasting insulin content in serum, and calculates the HOMA-IR score of insulin resistance index by formula. The serum TNF- 偽 level was detected by Elisa with the continuous wavelength enzymatic marker produced by American Molecular Instruments. The oral mucosa of the patient was examined by the same stomatologist and the site of RAU attack was recorded. Size and number. Four groups of personal data including age, sex, height, weight and past medical history were collected and recorded. The data were calculated and analyzed by SPSS22.0 statistical analysis software according to the experimental data. Results 1. The content of TNF- 偽 in RAU OB group was higher than that in RAU group and OB group. The concentration of glucose in RAU OB group was higher than that in RAU group (P 0.05) and that in OB group was higher than that in OB group (P 0.05) and in OB group was higher than that in control group (P 0.05) and P 0.05% Rau could be regarded as a main effect on blood glucose concentration. There was no significant effect of the two groups on blood glucose concentration. There was no significant interaction between the two groups in fasting insulin concentration (RAU). OB group is higher than RAU group and OB group P0.05P0.05P0.05RU group and OB group are higher than control group P0.05P0.05U. Rau and OB can affect insulin concentration as main effect, but there is no obvious interaction between them. HOMA-IR value of RAU OB group is higher than that of RAU group and OB group P0.05P0.05rau group and OB group is higher than control group P0.05P0.05ru group and OB group is higher than control group P0.05P0.05ru group and OB group is higher than control group P0.05P0.05ru group and OB group is higher than control group P0.05P0.05ru group and OB group is higher than control group P0.05P0.05P0.05ru group and OB group. Both OB and OB can affect the HOMA-IR value as the main effect, but there is no obvious interaction between them. The correlation analysis shows that, There was a positive correlation between serum TNF- 偽 content and HOMA-IR score (P 0.05). Conclusion: 1. The expression of TNF- 偽 IR in serum may increase in the active stage of patients with Rau. In obese individuals, it is more obvious that the serum fasting blood glucose level may be increased when the patients with RAU are in active phase. The expression of TNF- 偽 in serum is positively correlated with the insulin resistance index.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R781.5;R589.2

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