發(fā)布時間：2018-07-20 14:49

【摘要】：目的:原發(fā)性干燥綜合征(Primary Sj?gren’s Syndrome,p SS)是以侵犯唾液腺、淚腺等外分泌腺體,以大量淋巴細胞浸潤為特征的自身免疫性疾病。多項研究發(fā)現(xiàn),p SS的發(fā)病與EB病毒(Epstein-Barr virus,EBV)的感染相關(guān)。EB病毒核抗原-1(Epstein-Barr Nuclear Antigen-1,EBNA-1)和EB病毒核抗原-2(Epstein-Barr Nuclear Antigen-2,EBNA-2)是EBV潛伏期表達的核心抗原。通過檢測p SS患者外周血單個核細胞(Peripheral blood mononuclear cell,PBMC)EBV DNA拷貝數(shù),以及測定p SS患者唇腺組織中EBNA-1和EBNA-2的表達情況,探討EBV與p SS發(fā)病的關(guān)系。方法:應(yīng)用Real-time熒光定量PCR定量檢測32例p SS患者與28例正常對照PBMC中EBV DNA拷貝數(shù)。通過免疫組化的方法測定32例p SS患者及6例正常唇腺組織中EBNA-1和EBNA-2的表達情況(以細胞胞漿、胞核中出現(xiàn)棕黃色顆粒狀物質(zhì)為陽性)。結(jié)果:(1)p SS患者EB病毒DNA檢測陽性率100%(32/32),對照組EB病毒DNA檢測陽性率89.2%(25/28),經(jīng)檢驗,差異無統(tǒng)計學(xué)意義(P0.05)。(2)32例p SS患者EB病毒DNA拷貝數(shù)均值為26.2±10.85 copies/μg,28例對照組EB病毒DNA拷貝數(shù)均值為8.6±5.21 copies/μg,經(jīng)檢驗,患者組EB病毒DNA拷貝數(shù)均值明顯高于對照組,差異具有統(tǒng)計學(xué)意義(P0.05)。(3)32例p SS患者臨床表現(xiàn)與EB病毒DNA拷貝數(shù)比較顯示,腮腺腫大組較非腮腺腫大組EB病毒DNA拷貝數(shù)差異有統(tǒng)計學(xué)意義(P0.05)。32例p SS患者實驗室檢查結(jié)果與EBV-DNA之間的相關(guān)性分析顯示,Ig G與病毒DNA拷貝數(shù)呈正相關(guān)(p0.05)。(4)EBNA-1和EBNA-2在部分p SS患者唇腺組織浸潤的淋巴細胞,唇腺導(dǎo)管上皮細胞中可見陽性表達,而對照組唇腺組織未見陽性表達。p SS唇腺組織中EBNA-1的陽性率為68.8%(22/32),EBNA-2的陽性表達率62.5%(20/32),較正常對照組比較均有顯著統(tǒng)計學(xué)意義(P0.05)。(5)EBNA-1在p SS唇腺組織中陽性和陰性的患者在臨床表現(xiàn)和實驗室檢查方面無明顯差異性(P0.05)。EBNA-2在p SS唇腺組織中陽性和陰性的患者在臨床表現(xiàn)和實驗室檢查方面無明顯差異性(P0.05)。結(jié)論:(1)EBV復(fù)制可能參與p SS的發(fā)病。(2)p SS腮腺腫大的患者提示可能EBV復(fù)制活躍,加重發(fā)病。(3)高Ig G提示與EBV復(fù)制活躍相關(guān)。(4)EBNA-1、EBNA-2可能通過參與EBV感染而與p SS的發(fā)病相關(guān)。
[Abstract]:Objective: primary Sjgren's Syndromeg syndrome (SS) is an autoimmune disease characterized by invasion of exocrine glands such as salivary glands and lacrimal glands, and massive lymphocytic infiltration. Many studies have found that Epstein-Barr virus (EBV) infection and Epstein-Barr Nuclear Antigen-1EBNA-1 (EBNA-1) and Epstein-Barr Nuclear Antigen-2( EBNA-2) are the core antigens of EBV expression. The expression of EBNA-1 and EBNA-2 in labial gland of patients with PSS was determined by detecting the copy number of EBV DNA in peripheral blood mononuclear cells (PBMCs) of patients with PSS, and the relationship between EBV and PSS was studied. Methods: Real-time quantitative PCR was used to detect EBV DNA copy number in PBMC of 32 patients with PSS and 28 normal controls. The expression of EBNA-1 and EBNA-2 in 32 cases of PSS and 6 cases of normal labial gland were detected by immunohistochemical method. Results: (1) Epstein-Barr virus DNA positive rate was 100% (32 / 32) in patients with PSS and 89.2% (25 / 28) in controls. There was no significant difference (P0.05). (2). The average copy number of EBV DNA in 32 patients with PSS was 26.2 鹵10.85 copies/ 渭 g. The average value of EBV DNA copy number in 28 cases of control group was 8.6 鹵5.21 copies/ 渭 g, and the average value of EBV copy number in patients with PSS was significantly higher than that in control group. The difference was statistically significant (P0.05). (3). The clinical manifestations of 32 patients with PSS were compared with Epstein-Barr virus copy number (EBV). Epstein-Barr virus DNA copy number in parotid enlargement group was significantly different from that in non-parotid enlargement group (P0.05). The correlation analysis between EBV-DNA and EBV-DNA in 32 patients with PSS showed that Ig was positively correlated with viral DNA copy number (p0.05). (_ 4) EBNA-1 and EBNA-2 in the region. Lymphocytes infiltrated in labial gland of patients with PSS, Positive expression was found in epithelial cells of labial gland ducts. The positive rate of EBNA-1 was 62.8% (22 / 32) in the labial gland of the control group, which was significantly higher than that in the control group (P0.05). The positive rate of EBNA-1 in the labial gland tissue of PSS was 62.5% (20 / 32), which was significantly higher than that in the control group (P0.05). The positive rate of EBNA-1 in PSS labial gland was significantly higher than that in the control group (P0.05). There was no significant difference between clinical manifestation and laboratory examination (P0.05). There was no significant difference in clinical manifestation and laboratory examination between patients with EBNA-2 positive and negative in PSS labial gland (P0.05). Conclusion: (1) EBV replication may be involved in the pathogenesis of PSS. (2) the patients with PSS parotid gland enlargement may be active in EBV replication and aggravate the disease. (3) the high IgG hint may be related to EBV replication activity. (4) EBNA-1 EBNA-2 may be associated with the pathogenesis of PSS by participating in EBV infection.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2015
【分類號】：R593.2

【相似文獻】

相關(guān)期刊論文 前10條

1 王玉華;王鴻琳;溫曉宏;趙巖;曾小峰;杜德順;;基質(zhì)金屬蛋白酶-9在原發(fā)性干燥綜合征患者唇腺中的表達[J];臨床內(nèi)科雜志;2007年07期

2 康媛媛;聞妍;張英;孫妍;;細胞色素C在原發(fā)性干燥綜合征患者唇腺組織中表達的研究[J];口腔醫(yī)學(xué);2013年02期

3 于織波;張風(fēng)肖;寧曉然;閆永龍;齊fE;;白細胞介素17在原發(fā)性干燥綜合征患者唇腺中的表達及意義[J];廣東醫(yī)學(xué);2013年10期

4 小四島梧郎;扈傳午;;人口唇腺導(dǎo)管的排列和罕見的口唇腺管內(nèi)涎腺石[J];河北醫(yī)學(xué)院學(xué)報;1982年04期

5 何春華;張建;鄒霓;;白介素7在原發(fā)性干燥綜合征患者唇腺組織中的表達及其臨床意義[J];中國全科醫(yī)學(xué);2014年12期

6 竺紅;宮怡;王莉;朱蓉;池淑紅;朱彩俠;李海波;;原發(fā)性干燥綜合征患者唇腺組織中基質(zhì)金屬蛋白酶9、上皮型鈣黏附蛋白的表達[J];臨床薈萃;2008年20期

7 王玉華;趙巖;曾小峰;;基質(zhì)金屬蛋白酶-3在原發(fā)性干燥綜合征患者唇腺中的表達[J];軍醫(yī)進修學(xué)院學(xué)報;2009年01期

8 竺紅;王莉;朱蓉;王雪梅;楊吉娟;周少嵐;宮怡;;原發(fā)性干燥綜合征患者唇腺中熱休克蛋白60與細胞外基質(zhì)金屬蛋白酶誘導(dǎo)因子的表達及意義[J];臨床薈萃;2012年17期

9 莊俊漢;林華鵬;徐勝美;李博;張麗君;李劍松;葉志中;;γ干擾素及白細胞介素-4在干燥綜合征患者唇腺組織中的表達與唇腺組織中淋巴細胞浸潤的關(guān)系[J];贛南醫(yī)學(xué)院學(xué)報;2007年02期

10 竺紅;王莉;宮怡;朱蓉;池淑紅;李國富;王海英;朱彩俠;;基質(zhì)金屬蛋白酶-9與層黏連蛋白在原發(fā)性干燥綜合征唇腺中的表達[J];寧夏醫(yī)學(xué)院學(xué)報;2007年03期

相關(guān)會議論文 前10條

1 費允云;張文;李夢濤;張p，

本文編號：2133884