HLA-B27陽性AAU的臨床特征觀察及MCP-1在葡萄膜炎患者血清中的表達(dá)研究
發(fā)布時間：2019-07-09 13:47
【摘要】：目的 1、探討HLA-B27((human leucocyte antigen B27, HLA-B27)陽性急性前葡萄膜炎(acute anterior uveitis, AAU)的臨床特征。 2、通過檢測單核細(xì)胞趨化蛋白-1(monocyte chemoattractant protein-1,MCP-1)在AAU及小柳原田綜合癥(Vogt-Koyanagi-Harada, VKH)患者血清中的表達(dá),探討其在葡萄膜炎發(fā)病中的可能機(jī)制。 方法 1、收集83例2011年5月-2012年1月于我院診斷為AAU患者,按是否表達(dá)人類白細(xì)胞抗原B27分為兩組：即HLA-B27陽性組35例和HLA-B27陰性組48例,對兩組患者的臨床特征進(jìn)行統(tǒng)計學(xué)分析和比較。 2、同期收集62例葡萄膜炎患者(AAU43例,VKH19例)作為研究對象,對照組14例,提取血清。同樣將AAU患者分為HLA-B27陽性組和]HLA-B27陰性組；并將VKH患者按是否已使用激素治療分為兩組：未使用激素治療組和已使用激素治療組。采用酶聯(lián)免疫吸附試驗(Quantitative Enzyme-linked immunoassay, ELISA)法檢測各組血清中MCP-1的含量,對各組檢測數(shù)據(jù)進(jìn)行統(tǒng)計分析。 結(jié)果 1、 HLA-B27陽性AAU的臨床特點有發(fā)病年齡偏小、起病急、雙眼交替發(fā)病、角膜后沉著物呈粉塵狀、前房出現(xiàn)纖維素性滲出比例及復(fù)發(fā)率較高,常伴全身關(guān)節(jié)病變。 2、急性前葡萄膜炎HLA-B27陽性組與陰性組患者血清中MCP-1濃度分別為115.220±22.698pg/ml.102.210±38.689pg/ml,與對照組血清MCP-1濃度(107.900±21.655pg/ml)比較無統(tǒng)計學(xué)差異(P0.05)。未使用激素治療的VKH患者外周血清中MCP-1含量(217.370±38.751pg/ml)較正常組顯著增高(P0.05)。激素治療VKH組MCP-1含量(195.480±19.977pg/ml)略低于未治療組(P0.05),但仍高于正常組,二者比較差異有顯著性意義(P0.05)。 結(jié)論 1、HLA-B27陽性與陰性AAU臨床表現(xiàn)不盡相同,需注意HLA-B27陽性AAU患者的全身疾病。 2、血清MCP-1的表達(dá)在AAU無明顯變化,其表達(dá)上調(diào)可能參與了VKH的病理生理過程。
[Abstract]:Objective 1. To investigate the clinical features of HLA-B27 (human leucocyte antigen B 27, HLA-B27) positive acute anterior uveitis (acute anterior uveitis, AAU). 2. To investigate the possible mechanism of monocyte chemotactic protein-1 (monocyte chemoattractant protein-1,MCP-1 in the pathogenesis of uveitis by detecting the expression of monocyte chemotactic protein-1 (monocyte chemoattractant protein-1,MCP-1 in serum of patients with AAU and Vogt-Koyanagi-Harada, VKH. Methods 1. 83 patients with AAU diagnosed in our hospital from May 2011 to January 2012 were divided into two groups according to the expression of human leukocyte antigen B27: HLA-B27 positive group (n = 35) and HLA-B27 negative group (n = 48). The clinical features of the two groups were statistically analyzed and compared. 2. 62 patients with uveitis (AAU43, 19 VKH) were collected at the same time, and the serum was extracted from 14 patients in the control group. The patients with AAU were divided into HLA-B27 positive group and] HLA-B27 negative group, and VKH patients were divided into two groups according to whether they had been treated with hormone or not: non-hormone treatment group and hormone treatment group. Enzyme linked immunosorbent assay (Quantitative Enzyme-linked immunoassay, ELISA) was used to detect the content of MCP-1 in serum of each group, and the data of each group were statistically analyzed. Results 1. The clinical characteristics of HLA-B27 positive AAU were as follows: the age of onset was too young, the onset was urgent, the eyes occurred alternately, the posterior corneal deposition was dusty, the proportion of cellulose exudation and recurrence rate in anterior chamber were high, and it was often accompanied by systemic joint lesions. 2. The serum MCP-1 concentration in acute anterior uveitis positive group and negative group was 115.220 鹵22.698pg/ml.102.210 鹵38.689 PG / ml, which was not significantly different from that in control group (107.900 鹵21.655 PG / ml) (P 0.05). The content of MCP-1 in peripheral serum of VKH patients without hormone therapy (217.370 鹵38.751pg/ml) was significantly higher than that of normal group (P 0.05). The content of MCP-1 in VKH group (195.480 鹵19.977pg/ml) was slightly lower than that in non-treatment group (P 0.05), but still higher than that in normal group. There was significant difference between the two groups (P 0.05). Conclusion 1. The clinical manifestations of HLAB27 positive and negative AAU are not the same. Attention should be paid to the systemic diseases of HLA-B27 positive AAU patients. 2. There was no significant change in the expression of serum MCP-1 in AAU, and its up-regulation may be involved in the pathophysiological process of VKH.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R773
本文編號：2512186
[Abstract]:Objective 1. To investigate the clinical features of HLA-B27 (human leucocyte antigen B 27, HLA-B27) positive acute anterior uveitis (acute anterior uveitis, AAU). 2. To investigate the possible mechanism of monocyte chemotactic protein-1 (monocyte chemoattractant protein-1,MCP-1 in the pathogenesis of uveitis by detecting the expression of monocyte chemotactic protein-1 (monocyte chemoattractant protein-1,MCP-1 in serum of patients with AAU and Vogt-Koyanagi-Harada, VKH. Methods 1. 83 patients with AAU diagnosed in our hospital from May 2011 to January 2012 were divided into two groups according to the expression of human leukocyte antigen B27: HLA-B27 positive group (n = 35) and HLA-B27 negative group (n = 48). The clinical features of the two groups were statistically analyzed and compared. 2. 62 patients with uveitis (AAU43, 19 VKH) were collected at the same time, and the serum was extracted from 14 patients in the control group. The patients with AAU were divided into HLA-B27 positive group and] HLA-B27 negative group, and VKH patients were divided into two groups according to whether they had been treated with hormone or not: non-hormone treatment group and hormone treatment group. Enzyme linked immunosorbent assay (Quantitative Enzyme-linked immunoassay, ELISA) was used to detect the content of MCP-1 in serum of each group, and the data of each group were statistically analyzed. Results 1. The clinical characteristics of HLA-B27 positive AAU were as follows: the age of onset was too young, the onset was urgent, the eyes occurred alternately, the posterior corneal deposition was dusty, the proportion of cellulose exudation and recurrence rate in anterior chamber were high, and it was often accompanied by systemic joint lesions. 2. The serum MCP-1 concentration in acute anterior uveitis positive group and negative group was 115.220 鹵22.698pg/ml.102.210 鹵38.689 PG / ml, which was not significantly different from that in control group (107.900 鹵21.655 PG / ml) (P 0.05). The content of MCP-1 in peripheral serum of VKH patients without hormone therapy (217.370 鹵38.751pg/ml) was significantly higher than that of normal group (P 0.05). The content of MCP-1 in VKH group (195.480 鹵19.977pg/ml) was slightly lower than that in non-treatment group (P 0.05), but still higher than that in normal group. There was significant difference between the two groups (P 0.05). Conclusion 1. The clinical manifestations of HLAB27 positive and negative AAU are not the same. Attention should be paid to the systemic diseases of HLA-B27 positive AAU patients. 2. There was no significant change in the expression of serum MCP-1 in AAU, and its up-regulation may be involved in the pathophysiological process of VKH.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R773
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