本文關(guān)鍵詞： 原發(fā)性皮膚淀粉樣變 組織病理 免疫組化 組織細(xì)胞 角蛋白　出處：《廣西醫(yī)科大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的探討原發(fā)性皮膚淀粉樣變(Primary Cutaneous Amyloidosis, PCA)臨床表現(xiàn)、治療療效與皮損組織病理學(xué)表現(xiàn)的聯(lián)系,并且檢測PCA皮損組織淀粉樣物質(zhì)中CK5的表達(dá)及組織細(xì)胞表面CD16、CD206的表達(dá)情況,對PCA的發(fā)病機(jī)制作初步探討。方法采集30例PCA患者的臨床資料,設(shè)計觀察表隨訪記錄患者臨床治療情況；分析30例患者皮損組織病理學(xué)表現(xiàn)與臨床表現(xiàn)及治療療效的關(guān)系；通過免疫組化技術(shù)檢測患者皮損組織中淀粉樣物質(zhì)中CK5的表達(dá)情況及組織細(xì)胞表面CD16、CD206的表達(dá)情況。所得數(shù)據(jù)用SPSS16.0統(tǒng)計軟件進(jìn)行統(tǒng)計分析。結(jié)果原發(fā)性皮膚淀粉樣變病患者30例,男13人,女17人。其中,苔蘚樣型(LA)：20例,占66.7%；斑狀型(MA)：4例,占13.3%；雙型(BA)：5例,占16.7%。異色樣型：1例,占3.3%。22例患者伴有瘙癢,8例患者無瘙癢。30例患者皮損組織病理學(xué)表現(xiàn)均見表皮組織中散在不同程度的角化不良細(xì)胞或壞死的角質(zhì)形成細(xì)胞；伴有瘙癢癥狀的患者皮損組織1個真皮乳頭淀粉樣物質(zhì)中的炎癥細(xì)胞(組織細(xì)胞和淋巴細(xì)胞)計數(shù)的平均值(30.19±20.88),無瘙癢癥狀患者的為(14.74±2.73),兩者比較有顯著差異(P0.05)；炎癥細(xì)胞浸潤重(20個炎癥細(xì)胞/1個真皮乳頭)的患者與炎癥細(xì)胞浸潤輕(20炎癥細(xì)胞/1個真皮乳頭)的患者的治療前后評分無顯著差異(P0.05)。8例患者皮損組織中的淀粉樣物質(zhì)CK5灶狀表達(dá)；30例患者的皮損組織中組織細(xì)胞均未檢測到CD206表達(dá)。結(jié)論 (1)研究結(jié)果提示PCA皮損中的淋巴細(xì)胞及組織細(xì)胞浸潤程度與患者的瘙癢程度相關(guān),與療效無關(guān)聯(lián)。(2)PCA的淀粉樣物質(zhì)的形成可能與角質(zhì)形成細(xì)胞的凋亡、壞死相關(guān)聯(lián)。
[Abstract]:Objective to investigate the clinical manifestations of primary Cutaneous amyloidosissis (PCAs). The relationship between the therapeutic efficacy and histopathological manifestations of lesions, and the expression of CK5 in PCA lesions and the expression of CD16 / CD206 on the surface of tissue cells were detected. Methods the clinical data of 30 patients with PCA were collected and the clinical treatment was recorded by designing an observation table. The relationship between histopathological manifestations, clinical manifestations and therapeutic efficacy of 30 patients with skin lesions was analyzed. Immunohistochemical technique was used to detect the expression of amyloid CK5 and CD16 on the tissue surface. The expression of CD206. The data were analyzed by SPSS16.0 software. Results there were 30 patients with primary cutaneous amyloidosis, 13 males and 17 females. There were 20 cases (66.7%) of mossy type. There were 4 cases (13.3%) of the macular type. There were 5 cases (16.7%) of double type of Bafa, and 1 case of heterochromoid type: 1 case (3.3%), 22 cases with pruritus. The histopathological findings of 8 patients without pruritus and 30 patients with skin lesions showed that keratosis cells or necrotic keratinocytes were scattered in the epidermis to varying degrees. The average count of inflammatory cells (histocytes and lymphocytes) in one dermal papilla amyloid tissue in patients with pruritus was 30.19 鹵20.88). The number of patients without pruritus symptom was 14.74 鹵2.73g, there was significant difference between the two groups (P 0.05). There was no significant difference in the scores before and after treatment between patients with heavy infiltration of inflammatory cells (20 inflammatory cells / 1 dermal papilla) and patients with mild inflammatory cell infiltration / 1 dermal papilla (P < 0.05). The focal expression of amyloid CK5 in lesions of patients with P0.05 was observed. CD206 expression was not detected in the lesions of 30 patients. The results suggest that the degree of infiltration of lymphocytes and histocytes in the lesions of PCA is related to the degree of pruritus. The formation of amyloid in PCA may be associated with apoptosis and necrosis of keratinocytes.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R758.6

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 劉紅春,張順財;淀粉樣變[J];肝臟;2000年03期

2 史玉玲;何桂蘭;;異維A酸治療原發(fā)性皮膚淀粉樣變臨床觀察[J];醫(yī)學(xué)研究通訊;2001年03期

3 劉小軍,潘康儉;原發(fā)性皮膚淀粉樣變109例臨床和病理分析[J];皮膚病與性病;2002年04期

4 鄧安國,蘇華;繼發(fā)性腎淀粉樣變的發(fā)病機(jī)制與治療[J];臨床內(nèi)科雜志;2002年06期

5 李雁,彭德榮;異維A酸治療32例原發(fā)性皮膚淀粉樣變臨床觀察[J];中國廠礦醫(yī)學(xué);2005年03期

6 Parsi K. ,Kossard S. ,張憲旗;熱敏苔癬狀淀粉樣變[J];世界核心醫(yī)學(xué)期刊文摘(皮膚病學(xué)分冊);2005年05期

7 李別非,江亞文;系統(tǒng)性淀粉樣變1例[J];中國老年學(xué)雜志;2005年11期

8 李祖海;余英豪;;淀粉樣變誤診為原發(fā)性腎病綜合征2例報告[J];安徽醫(yī)學(xué);2006年05期

9 劉瑩;張輝;倪然;張筠;;系統(tǒng)性淀粉樣變26例臨床分析[J];醫(yī)藥論壇雜志;2010年14期

10 黃志英;陳廣田;;肺結(jié)核Ou發(fā)淀粉樣變兩例報告[J];中國防癆雜志;1965年02期

相關(guān)會議論文 前10條

1 ;系統(tǒng)性淀粉樣變1例[A];2005年浙江皮膚性病學(xué)學(xué)術(shù)年會論文匯編[C];2005年

2 呂中法;;皮膚淀粉樣變?[A];2009年浙江省皮膚病學(xué)術(shù)會議論文匯編[C];2009年

3 房麗華;蔣明;;原發(fā)性干燥綜合征合并淀粉樣變?nèi)齕A];中華醫(yī)學(xué)會全國風(fēng)濕病學(xué)年會論文匯編[C];2003年

4 徐凌;蔡柏薔;鐘旭;朱元玨;;淀粉樣變的呼吸系統(tǒng)表現(xiàn)59例分析[A];中華醫(yī)學(xué)會第七次全國呼吸病學(xué)術(shù)會議暨學(xué)習(xí)班論文匯編[C];2006年

5 彭建中;;局限性結(jié)節(jié)性原發(fā)性皮膚淀粉樣變1例[A];2008全國中西醫(yī)結(jié)合皮膚性病學(xué)術(shù)會議論文匯編[C];2008年

6 蔡綏R，

本文編號：1453861