本文選題：硅油 + 晶狀體上皮細(xì)胞�。� 參考：《大連醫(yī)科大學(xué)》2011年碩士論文

【摘要】：目的:細(xì)胞凋亡又被稱為程序性細(xì)胞死亡,是一種區(qū)別于細(xì)胞壞死的特殊細(xì)胞死亡形式,指由體內(nèi)外因素觸發(fā)細(xì)胞內(nèi)預(yù)存的死亡程序而導(dǎo)致的細(xì)胞主動性死亡方式。隨著凋亡與疾病關(guān)系的研究,晶狀體上皮細(xì)胞凋亡和白內(nèi)障的關(guān)系已引起人們的注意。近年來的研究表明,晶狀體上皮細(xì)胞凋亡是除先天性白內(nèi)障外各種白內(nèi)障的共同細(xì)胞學(xué)基礎(chǔ)。隨著玻璃體視網(wǎng)膜手術(shù)技術(shù)的發(fā)展,硅油作為一種玻璃體填充物,已用于復(fù)雜性玻璃體視網(wǎng)膜病變并取得了令人滿意的效果。硅油填充術(shù)后隨訪中,白內(nèi)障作為硅油填充眼最常見的并發(fā)癥,其發(fā)生率幾乎高達(dá)100%。白內(nèi)障的發(fā)展不僅可以使患者的視力再次下降,而且影響了眼底檢查,并可能延誤眼底病的診治,因此硅油填充眼并發(fā)白內(nèi)障的發(fā)生、發(fā)展已越來越受到眼科醫(yī)生們的重視,但硅油引起白內(nèi)障的發(fā)病機(jī)制目前尚未明確。本課題通過觀察Bax蛋白在硅油眼并發(fā)白內(nèi)障晶狀體上皮細(xì)胞上的表達(dá)及作用,探討晶狀體上皮細(xì)胞凋亡與硅油眼并發(fā)障的相關(guān)性及硅油引起白內(nèi)障的發(fā)病機(jī)制。 方法:收集45例不同類型病人的晶狀體前囊膜,其中包括老年性白內(nèi)障患者20例20眼,硅油眼并發(fā)白內(nèi)障患者18例18眼,健康成人各種原因?qū)е碌木铙w脫位患者7例7眼,通過HE染色及免疫組化的方法觀察Bax蛋白在老年性白內(nèi)障、硅油眼并發(fā)白內(nèi)障及晶狀體脫位患者的晶狀體上皮細(xì)胞中的表達(dá)情況。 結(jié)果: 1.光鏡下各組晶狀體上皮細(xì)胞的形態(tài):晶狀體脫位的晶狀體上皮細(xì)胞分布均勻,大小一致,細(xì)胞間相互嵌合,細(xì)胞核呈圓形,大小均勻一致;老年性白內(nèi)障晶狀體上皮細(xì)胞較晶狀體脫位的晶體上皮細(xì)胞體積變小,前囊膜皺縮,形態(tài)極其不規(guī)則,與囊膜分離,存在細(xì)胞腫大,細(xì)胞間隙加大,細(xì)胞核大小不一致及細(xì)胞重疊的現(xiàn)象;硅油眼并發(fā)白內(nèi)障可見前囊膜卷曲,晶狀體上皮變性、纖維化生、增生,細(xì)胞形態(tài)各異,多呈扁橢圓形或橢圓形,排列紊亂,細(xì)胞間隙擴(kuò)大,部分前囊膜下細(xì)胞基質(zhì)中見硅油小滴。 2.采用免疫組化技術(shù)檢測bax蛋白在各組晶狀體上皮細(xì)胞中的表達(dá):bax蛋白在老年性白內(nèi)障及硅油眼并發(fā)白內(nèi)障晶狀體上皮細(xì)胞中有表達(dá),在晶狀體脫位晶狀體上皮細(xì)胞中無表達(dá),三組之間bax蛋白表達(dá)有顯著性差異(P〈0.05),且三組中兩兩之間亦存在統(tǒng)計學(xué)差異(P〈0.05)。bax蛋白在硅油眼并發(fā)白內(nèi)障晶狀體上皮細(xì)胞的表達(dá)強(qiáng)于老年性白內(nèi)障晶狀體上皮細(xì)胞的表達(dá),二者之間存在統(tǒng)計學(xué)差異(P〈0.05)。 結(jié)論:Bax蛋白與硅油眼并發(fā)白內(nèi)障的發(fā)生、發(fā)展存在相關(guān)性;老年性白內(nèi)障及硅油眼并發(fā)白內(nèi)障的發(fā)生可能與其晶狀體上皮細(xì)胞凋亡有相關(guān)性,但二者的發(fā)病機(jī)制可能存在差異。
[Abstract]:Objective: apoptosis, also known as programmed cell death, is a special form of cell death, which is different from cell necrosis. With the study of the relationship between apoptosis and disease, the relationship between lens epithelial cell apoptosis and cataract has attracted people's attention. Recent studies have shown that lens epithelial cell apoptosis is the common cytological basis of cataract except congenital cataract. With the development of vitreoretinal surgery, silicone oil, as a kind of vitreous filler, has been used in complicated vitreoretinopathy with satisfactory results. Cataract is the most common complication of silicone oil-filled eyes. The development of cataract can not only decrease the visual acuity of the patients again, but also affect the fundus examination, and may delay the diagnosis and treatment of fundus disease. Therefore, the occurrence of cataract in silicone oil filled eyes has been paid more and more attention by ophthalmologists. However, the pathogenesis of cataract caused by silicone oil is not clear. In this study, we observed the expression and role of Bax protein in lens epithelial cells of silicone oil eyes complicated with cataract, and discussed the relationship between apoptosis of lens epithelial cells and complicated barrier of silicone oil eyes and the pathogenesis of cataract induced by silicone oil. Methods: the anterior capsule of lens was collected from 45 patients of different types, including 20 cases of senile cataract (20 eyes), 18 eyes of silicone eye (18 cases) with cataract, 7 cases (7 eyes) of lens dislocation caused by various causes in healthy adults. The expression of Bax protein in lens epithelial cells of senile cataract, silicone oil eye complicated cataract and lens dislocation was observed by HE staining and immunohistochemistry. Results: 1. The morphology of lens epithelial cells in each group under light microscope: the lens epithelial cells of lens dislocation were evenly distributed and uniform in size, intercellular chimera, round nucleus and uniform size. The volume of lens epithelial cells in senile cataract is smaller than that in lens dislocation, the anterior capsule shrinks, the shape is extremely irregular, the cells are enlarged and the intercellular space is enlarged. In silicone oil eyes, the anterior capsule curl, lens epithelium degeneration, fibrogenesis, proliferation, cell shape are different, most of them are flat ellipse or ellipse, and the arrangement is disordered. The intercellular space was enlarged and a small drop of silicon oil was found in the matrix of some subcapsular cells. 2. The expression of bax protein in lens epithelial cells was detected by immunohistochemical technique. The expression of bax protein was detected in the lens epithelial cells of senile cataract and silicone eye complicated with cataract, but not in the lens epithelial cells of lens dislocation. There was significant difference in the expression of bax protein among the three groups (P < 0.05), and there was also a significant difference in the expression of P < 0.05).bax protein between the two groups. The expression of P < 0.05).bax protein in the lens epithelial cells of silicone oil eyes complicated with cataract was stronger than that in the lens epithelial cells of senile cataract. There was statistical difference between the two groups (P < 0.05). Conclusion there is a correlation between the protein of 10% Bax and the occurrence and development of cataract in silicone oil eyes, and the occurrence of senile cataract and cataract complicated with silicone oil eye may be related to the apoptosis of lens epithelial cells, but the pathogenesis of them may be different.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R776.1

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