本文關(guān)鍵詞： 白細(xì)胞介素-4 腫瘤壞死因子-α 叉頭蛋白轉(zhuǎn)錄因子3 細(xì)胞毒T淋巴細(xì)胞抗原-4 慢性扁桃體炎 扁桃體肥大　出處：《安徽醫(yī)科大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：研究背景及目的慢性扁桃體炎(chronic tonsillitis,CT)常起因于扁桃體急性炎癥反復(fù)發(fā)作或扁桃體隱窩引流不暢,窩內(nèi)病毒細(xì)菌滋生感染[1]。扁桃體肥大(tonsillar hypertrophy,TH)即腺樣體肥大,是發(fā)生在咽扁桃體的生理性或病理性的增生肥大,反復(fù)炎癥刺激、咽部感染、營(yíng)養(yǎng)不良、急性傳染病和體質(zhì)等是其誘發(fā)因素[3],尤其在寒冷、潮濕和氣候多變的地區(qū)多發(fā)。本文研究的對(duì)象是慢性扁桃體炎和扁桃體生理性肥大的患者。本研究主要通過(guò)檢測(cè)白細(xì)胞介素-4(interleukin-4,IL-4)、腫瘤壞死因子-α(tumor necrosis factor-α,TNF-α)、叉頭蛋白轉(zhuǎn)錄因子-3(forkhead box P3,Foxp3)和細(xì)胞毒T淋巴細(xì)胞抗原-4(Cytotoxic T-Lymphocyte Antigen 4,CTLA-4)在CT組和TH組扁桃體組織中的表達(dá)差異與分布特征,并探討他們?cè)贑T發(fā)病發(fā)展過(guò)程中可能發(fā)揮的免疫學(xué)作用和機(jī)制。方法從安徽醫(yī)科大學(xué)第一附屬醫(yī)院耳鼻咽喉頭頸外科接受扁桃體全切術(shù)的患者中收取CT患者扁桃體標(biāo)本35例為實(shí)驗(yàn)組,TH患者扁桃體標(biāo)本23例為對(duì)照組。用HE染色法觀察兩組扁桃體組織的病理改變,用免疫組化實(shí)驗(yàn)檢測(cè)IL-4、TNF-α、Foxp3在兩組扁桃體組織中的表達(dá)差異與分布特征,用免疫熒光技術(shù)檢測(cè)CTLA-4在兩組扁桃體組織中的表達(dá)差異和分布特征,用實(shí)時(shí)熒光定量PCR實(shí)驗(yàn)檢測(cè)IL-4m RNA、TNF-αm RNA、Foxp3 m RNA及CTLA-4 m RNA在兩組扁桃體的相對(duì)表達(dá)定量。結(jié)果1)HE染色結(jié)果顯示CT組扁桃體病理結(jié)構(gòu)以濾泡增生和生發(fā)中心的變化為主要特征,TH組發(fā)現(xiàn)濾泡增生伴隨明顯的“星空”現(xiàn)象。2)免疫組化實(shí)驗(yàn)結(jié)果發(fā)現(xiàn),相對(duì)于TH組而言,CT組的IL-4、TNF-α、Foxp3的表達(dá)均顯著上調(diào)。3)免疫熒光結(jié)果顯示CT組扁桃體組織中CTLA-4的平均熒光強(qiáng)度和密度均明顯高于TH組。4)實(shí)時(shí)熒光定量PCR實(shí)驗(yàn)結(jié)果顯示CT組IL-4m RNA,TNF-αm RNA,Foxp3m RNA和CTLA-4 m RNA的相對(duì)表達(dá)量顯著高于HT組(n=58,t=6.294,t=6.294,P值分別為P0.01,P0.05,P0.0,5,P0.01),差異有統(tǒng)計(jì)學(xué)意義。結(jié)論IL-4、TNF-α、Foxp3及CTLA-4在CT疾病的免疫應(yīng)答過(guò)程中發(fā)揮重要的免疫促進(jìn)或免疫抑制作用,影響CT炎癥反應(yīng)的發(fā)生發(fā)展。
[Abstract]:Background and objective chronic tonsillitis (CTT) is often caused by recurrent acute inflammation of the tonsillitis or poor drainage of the tonsillar recess. Viral infection in nest. [1. Tonsillar hypertrophy of tonsillar hypertrophy, or adenoid hypertrophy, occurs in the pharyngeal tonsillar hypertrophy, which occurs in the pharyngeal tonsil. Pharynx infection, malnutrition, acute infectious disease and physical constitution are the predisposing factors. [3], especially in cold. The subjects of this study are patients with chronic tonsillitis and physiologic hypertrophy of tonsil. Interleukin-4. IL-4, tumor necrosis factor- 偽 (TNF- 偽). Forkhead box P3. Foxp3) and cytotoxic T-Lymphocyte Antigen 4. CTLA-4) expression and distribution in tonsils of CT and th groups. To explore the immunological role and mechanism they may play in the development of CT. Methods CT patients were collected from patients undergoing total tonsillectomy in otolaryngology and head and neck surgery of the first affiliated Hospital of Anhui Medical University. The tonsils were collected from 35 cases of experimental group. Twenty-three tonsils of th patients were taken as control group. The pathological changes of tonsil tissue were observed by HE staining and IL-4 TNF- 偽 was detected by immunohistochemistry. The expression and distribution of Foxp3 in tonsils of two groups were detected by immunofluorescence technique. The expression and distribution of CTLA-4 in tonsils of two groups were detected by immunofluorescence technique. IL-4m RNAs TNF- 偽 m RNA were detected by real-time fluorescence quantitative PCR assay. Relative quantitative expression of Foxp3 m RNA and CTLA-4 m RNA in tonsils of two groups. Results 1). The pathological structure of tonsil in CT group was characterized by follicular hyperplasia and germinal center. In th group, follicular hyperplasia was found with obvious "starry sky" phenomenon. 2) Immunohistochemical results showed that IL-4 TNF- 偽 in CT group was higher than that in th group. The results of immunofluorescence showed that the average fluorescence intensity and density of CTLA-4 in tonsils of CT group were significantly higher than those of th group. 4). The results of real-time fluorescence quantitative PCR showed IL-4m RNA in CT group. The relative expression of Foxp3m RNA and CTLA-4 m RNA in TNF- 偽 m RNAs was significantly higher than that in HT group. P value was P0.01P0.05P0.05P0.01a, the difference was statistically significant. Conclusion IL-4 TNF- 偽. Foxp3 and CTLA-4 play an important role in the immune response of CT disease and affect the development of CT inflammation.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R766.18

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