本文關(guān)鍵詞： 轉(zhuǎn)化生長(zhǎng)因子-β2 I型膠原 增生性玻璃體視網(wǎng)膜病變 增生性糖尿病視網(wǎng)膜病變 免疫組化法　出處：《鄭州大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：增生性玻璃體視網(wǎng)膜病變（proliferative viteroretinopathy，PVR）、增生性糖尿病視網(wǎng)膜病變（proliferative diabetic retinopathy，PDR）是臨床上常見(jiàn)的兩種眼內(nèi)纖維增生性疾病，具有難以治愈，預(yù)后較差等特點(diǎn)，使患者的視力嚴(yán)重下降，甚至失明。PVR、PDR具有相似的病理特征，共同點(diǎn)是在視網(wǎng)膜前形成纖維增生膜和在視網(wǎng)膜下形成纖維條索，收縮、牽拉引起視網(wǎng)膜脫離，使它們?cè)谂R床上治療起來(lái)相當(dāng)棘手。但是二者也有不同點(diǎn)，其本質(zhì)的區(qū)別在于PDR增生膜內(nèi)有新生血管的形成而PVR增生膜內(nèi)無(wú)新生血管。以往的研究認(rèn)為轉(zhuǎn)化生長(zhǎng)因子β2（transforming growth factor-β2，TGF-β2）和I型膠原參與了細(xì)胞外基質(zhì)和新生血管的形成。測(cè)定TGF-β2和I型膠原在PVR、PDR患者視網(wǎng)膜前的增生膜中的表達(dá)情況及這兩種蛋白之間的關(guān)系有助于進(jìn)一步了解這兩種疾病的形成機(jī)制。 目的 通過(guò)檢測(cè)TGF-β2，I型膠原在PVR、PDR患者增生膜中的表達(dá)情況及這兩種蛋白之間的關(guān)系，探討其在PVR、PDR發(fā)生中的作用及機(jī)制。 方法 利用HE染色及免疫組化法（immunohistochemistry，IHC）對(duì)PDR、PVR/C級(jí)和PVR/D級(jí)患者玻璃體切除術(shù)中所取的增生膜進(jìn)行染色及對(duì)TGF-β2、I型膠原進(jìn)行檢測(cè)，其中對(duì)照組6例6眼，PVR組24例24眼，其中PVR/C級(jí)組13例13眼，PVR/D級(jí)組11例11眼，PDR組12例12眼。 結(jié)果 HE染色結(jié)果示：兩種增生膜中均由成纖維細(xì)胞、上皮細(xì)胞及膠原纖維束等組成，光學(xué)顯微鏡下觀察免疫組化染色結(jié)果示：TGF-β2和I型膠原在對(duì)照組中很少見(jiàn)，TGF-β2主要在PVR、PDR增生膜內(nèi)增生細(xì)胞的胞漿和細(xì)胞膜表面表達(dá)，I型膠原主要在增生膜的細(xì)胞外基質(zhì)中表達(dá)。采用Biosens Digital ImagingAnalysis Systems分析系統(tǒng)對(duì)圖像中陽(yáng)性表達(dá)部位分析得出：TGF-β2、I型膠原平均灰度值分別為(均數(shù)±標(biāo)準(zhǔn)差)：對(duì)照組：54.62±8.37，63.32±7.81；PVR/C級(jí)組：178.25±11.30，198.74±16.23；PVR/D級(jí)組：229.17±14.25，287.33±9.78；PVR組（PVR/C級(jí)組和PVR/D級(jí)組）：203.71±12.24，243.04±13.05；PDR組：203.84±7.82，247.81±11.17。應(yīng)用SPSS17.0分析軟件進(jìn)行統(tǒng)計(jì)分析，先行方差齊性檢驗(yàn)，，再行多組間兩兩比較的LSD-t檢驗(yàn)及Spearson相關(guān)分析，以P0.05為差異有統(tǒng)計(jì)學(xué)意義。PVR/C級(jí)組、PVR/D級(jí)組及PDR組中TGF-β2、I型膠原的平均灰度明顯高于對(duì)照組(P0.05)，PVR/D組中TGF-β2、I型膠原的平均灰度顯著高于PVR/C組(P0.05)，PDR組TGF-β2、I型膠原的平均灰度和PVR組相比無(wú)統(tǒng)計(jì)學(xué)差異（P0.05），經(jīng)相關(guān)性分析得出：PVR、PDR患者增生膜中TGF-β2和I型膠原的表達(dá)具有關(guān)聯(lián)性（r=0.775，P0.05）。 結(jié)論 1．TGF-β2、I型膠原共同參與了PVR、PDR增生膜的形成； 2．隨著PVR的進(jìn)展，TGF-β2、I型膠原在增生膜中的表達(dá)呈上升趨勢(shì)且二者的表達(dá)具有強(qiáng)相關(guān)性；
[Abstract]:Proliferative vitreoretinopathy (PVR). Proliferative diabetic retinopathy (PDR) is a common intraocular fibroproliferative disease. With the characteristics of difficult to cure and poor prognosis, the visual acuity of the patients was seriously decreased, even blindness. PVR PDR had similar pathological characteristics. The common denominator is the formation of fibrous proliferative membrane before the retina and the formation of the fibrous cord under the retina, which causes retinal detachment due to contraction and pulling, which makes them very difficult to treat clinically. However, there are also differences between the two. The essential difference lies in the formation of neovascularization in the proliferative membrane of PDR and the absence of neovascularization in the proliferative membrane of PVR. Transforming growth factor- 尾 2. TGF- 尾 2) and type I collagen were involved in the formation of extracellular matrix and neovascularization. TGF- 尾 2 and type I collagen were measured in PVR. The expression of preretinal proliferative membrane and the relationship between these two proteins in PDR patients are helpful to further understand the formation mechanism of these two diseases. Purpose By detecting the expression of TGF- 尾 _ 2 type I collagen in the proliferative membrane of patients with PVR, and the relationship between these two proteins, the role and mechanism of TGF- 尾 _ 2 I collagen in the pathogenesis of PDR of PVR were investigated. Method PDR was treated with HE staining and immunohistochemical method. The proliferative membranes of PVR/C and PVR/D grade patients were stained and the type I collagen of TGF- 尾 2 was detected in 6 cases and 6 eyes in the control group. There were 24 cases (24 eyes) in PVR group, including 13 cases (13 eyes) in PVR/C grade group (13 eyes), 11 cases (11 eyes) in PVR/C grade D group (11 eyes) and 12 eyes (12 eyes) in PVR/C group. Results The results of HE staining showed that the two proliferative membranes were composed of fibroblasts, epithelial cells and collagenous bundles. The immunohistochemical staining under optical microscope showed that TGF- 尾 2 and collagen I were rare in the control group. TGF- 尾 2 was mainly found in PVR. The expression of cytoplasm and cell membrane surface of proliferative cells in PDR proliferative membrane. Type I collagen was mainly expressed in extracellular matrix of proliferative membrane. Biosens Digital ImagingAnalysis was used. The Systems analysis system analyzed the positive expression of TGF- 尾 2 in the image. The average gray values of type I collagen were (mean 鹵standard deviation): control group: 54.62 鹵8.37 鹵63.32 鹵7.81; PVR/C group: 178.25 鹵11.30 鹵198.74 鹵16.23; PVR/D group: 229.17 鹵14.25 + 287.33 鹵9.78; PVR group: PVR / C group and PVR/D group: W 203.71 鹵12.24 鹵243.04 鹵13.05; PDR group: 203.84 鹵7.82 鹵247.81 鹵11.17.The statistical analysis was carried out with SPSS17.0 software, and the homogeneity of variance was tested first. The LSD-t test and Spearson correlation analysis of pairwise comparison between the two groups were carried out again, with P0.05 as the difference. There was statistical significance in the PVR / C group. The average grayscale of TGF- 尾 _ 2 type I collagen in PVR/D group and PDR group was significantly higher than that in control group (P 0.05). The average grayscale of type I collagen was significantly higher than that of PVR/C group (P 0.05). There was no significant difference between PVR group and PVR group (P 0.05). The correlation analysis showed that the expression of TGF- 尾 2 and type I collagen in the proliferative membrane of the patients with PDR was correlated with the expression of TGF- 尾 2 and type I collagen. Conclusion 1. Type I collagen of TGF- 尾 2 was involved in the formation of PDR proliferative membrane of PVR. 2. With the development of PVR, the expression of TGF- 尾 _ 2 I collagen in proliferative membrane showed an upward trend, and the expression of TGF- 尾 _ 2 I collagen was strongly related to the expression of TGF- 尾 _ (2) I collagen.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R774.1

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