發(fā)布時(shí)間：2018-05-03 13:09

  本文選題：細(xì)胞間粘附分子-1 + 先天性血管瘤��； 參考：《桂林醫(yī)學(xué)院》2012年碩士論文

【摘要】：目的：通過對嬰幼兒增生期先天性血管瘤激光治療前后的臨床表現(xiàn)及血管瘤組織病理形態(tài)學(xué)特點(diǎn)的觀察,以及測定治療前后患兒血清中sICAM-1和組織中mICAM-1的情況,探討：①ICAM-1在診斷嬰幼兒先天性血管瘤是否處于增生期中的臨床意義。②長脈寬1064nmNd:YAG激光治療嬰幼兒先天性血管瘤的臨床療效。方法：研究對象為2010年8月-2011年8月到桂林醫(yī)學(xué)院附屬醫(yī)院皮膚科激光美容門診就診的12個(gè)月內(nèi)的增生期先天性血管瘤患兒50例。1.所有患兒給予可調(diào)長脈寬1064nm Nd:YAG激光治療2次,1次/4周,隨訪和記錄患兒治療前及治療后4周的臨床觀察數(shù)據(jù)。2.激光治療前及治療4周后運(yùn)用ELISA方法及免疫組化方法測定血清中sICAM-1和組織中mICAM-1的水平,并分別與正常血清對照組和正常組織對照組比較。結(jié)果：1.50例血管瘤患兒激光治療8周后,臨床療效情況如下：Ⅰ級4例(8%),Ⅱ級19例(38%),Ⅲ級20例(40%),Ⅳ級7例(14%)。其中,6個(gè)月內(nèi)的患兒26例： Ⅰ級1例(3.85%),Ⅱ級9例(34.62%),Ⅲ級12例(46.15%),Ⅳ級4例(15.38%)；大于6個(gè)月的患兒24例： Ⅰ級3例(12.5%),Ⅱ級10例(41.67%),Ⅲ級8例(33.33%),Ⅳ級3例(12.5%)。兩組患兒療效比較差異有顯著性(P0.05)。2.50例血管瘤患兒治療前血清中的sICAM-1為(622.03±71.91)μ g/L,正常血清組sICAM-1為(197.29±38.87)μ g/L,兩者比較差異有顯著性(P0.01)；激光治療后4周患兒血清sICAM-1為(597.32±81.60)μ g/L,與正常對照組比較,差異有顯著性(P0.01)；治療前與治療后4周比較,差異有顯著性(P0.05)。3.50例血管瘤患兒治療前瘤體組織mICAM-1的表達(dá)顯著強(qiáng)于激光治療后4周及正常組織對照組(P0.01)；治療4周后組織mICAM-1的表達(dá)結(jié)果比治療前減弱,差異有顯著性(P0.05)。結(jié)論：1.ICAM-1在先天性血管瘤的表達(dá)與血管的增生和密度有關(guān),血管瘤增生期表達(dá)增高,激光干預(yù)致血管瘤消退后呈現(xiàn)下降趨勢,提示ICAM-1可能與血管瘤的增生活性有關(guān)。2.嬰幼兒先天性血管瘤患兒經(jīng)激光治療前后,血清sICAM-1和瘤體組織中mICAM-1的變化趨勢一致,提示檢測外周血sICAM-1的水平可以反映血管瘤組織中mICAM-1的表達(dá)水平。3.sICAM-1可能是判斷血管瘤患兒是否處于增生期以及療效判定的輔助檢測指標(biāo)之一。4.長脈寬1064nmNd:YAG激光治療增生期嬰幼兒先天性血管瘤療效確切,副作用少,方法可靠。5.年齡6個(gè)月內(nèi)的血管瘤患兒激光治療效果優(yōu)于年齡大于6個(gè)月的患兒,提示對于先天性血管瘤應(yīng)及早進(jìn)行臨床干預(yù),以期獲得更好的臨床效果。
[Abstract]:Objective: to observe the clinical manifestations and histopathological features of congenital hemangioma in children with hyperplastic phase before and after laser treatment, and to determine the sICAM-1 in serum and mICAM-1 in tissues before and after treatment. To investigate the clinical significance of the diagnosis of infantile congenital hemangioma with 1: 1 ICAM-1. 2 the clinical effect of long pulse width 1064nmNd:YAG laser in the treatment of infantile congenital hemangioma. Methods: from August 2010 to August 2011, 50 children with hyperplastic congenital hemangioma were enrolled in the Department of Dermatology, Department of Dermatology, affiliated Hospital of Guilin Medical College. All the children were treated with adjustable pulse width 1064nm Nd:YAG laser for 2 times / 4 weeks. The clinical observation data before and after treatment were recorded and followed up. 2. 2. The levels of sICAM-1 in serum and mICAM-1 in tissues were determined by ELISA and immunohistochemistry before and 4 weeks after laser therapy and were compared with those in normal serum and normal tissue control groups. Results after 8 weeks of laser treatment in 1.50 children with hemangioma, the clinical results were as follows: grade 鈪，

本文編號：1838603