【摘要】：[目的]探討頜面部惡性腫瘤與頸動脈粥樣硬化性病變的相關(guān)性及術(shù)前頸部血管多普勒超聲在評估頜面部惡性腫瘤患者頸部血管的臨床應(yīng)用價值。并探討組織因子在頜面部惡性腫瘤患者發(fā)生頸動脈粥樣硬化性病變中的作用。[方法]1.隨機(jī)選取2015年12月-2017年4月在我院收治的頜面部腫瘤初診患者205例,臨床上排除頸部腫塊。行頸部血管多普勒超聲檢查,分析其頸部血管情況。采用統(tǒng)計軟件SPSS 24.0對良惡性腫瘤兩組患者的基本情況及頸動脈粥樣硬化病變情況等數(shù)據(jù)進(jìn)行分析,計數(shù)資料采用χ2檢驗,用率表示,以P0.05為差異有統(tǒng)計學(xué)意義。2.隨機(jī)選取2014年5月-2017年4月在我院就診的口腔癌30例患者,其中低分化鱗癌15例,高分化鱗癌患者15例,以15例口腔白斑患者做對照,采用免疫組化法檢測組織中TF (組織因子)的表達(dá)情況。采用統(tǒng)計軟件SPSS 24.0對數(shù)據(jù)進(jìn)行分析,以P0. 05為差異有統(tǒng)計學(xué)意義。[結(jié)果]第一部分:共205例腫瘤患者,年齡50.9±12.7歲。良性腫瘤組中男性65例,女性56例。惡性腫瘤組中男性54例,女性30例,無統(tǒng)計學(xué)差異。惡性腫瘤組患者中動脈粥樣硬化發(fā)生率(48.8%)明顯高于良性腫瘤患者(30.6%)(P=0.008),差異具有統(tǒng)計學(xué)意義。按年齡分層分析,小于45歲,兩組間頸動脈粥樣硬化發(fā)生率分別為(10.3%和11.4%),無明顯差異(P=0.892)。大于或等于45歲,惡性腫瘤組患者中頸動脈粥樣硬化發(fā)生率(69.1%)明顯高于良性腫瘤患者(41.6%),具有差異具有統(tǒng)計學(xué)意義(P=0.023)。第二部分:TF在白斑中的表達(dá)含量低于高分化鱗癌及低分化鱗癌,三組之間差異具有統(tǒng)計學(xué)意義(P=0.000)。[結(jié)論]1.頜面部惡性腫瘤與頸動脈粥樣硬化性病變的發(fā)生存在相關(guān)性。2.頜面部惡性腫瘤患者術(shù)前行頸部血管多普勒超聲檢查是必要的,其可提供重要的信息,預(yù)防術(shù)前、術(shù)后嚴(yán)重并發(fā)癥的發(fā)生。3.組織因子在頜面部惡性腫瘤患者發(fā)生頸動脈粥樣硬化性病變中起促進(jìn)作用。
[Abstract]:[objective] to investigate the correlation between maxillofacial malignant tumor and carotid atherosclerotic lesion, and to evaluate the clinical value of preoperative cervical vascular Doppler ultrasound in the evaluation of cervical vessels in patients with maxillofacial malignant tumor. To explore the role of tissue factor in carotid atherosclerosis in patients with maxillofacial malignant tumor. [methods] 1. A total of 205 patients with maxillofacial tumors were randomly selected from December 2015 to April 2017. The cervical blood vessels were examined by Doppler ultrasound. The statistical software SPSS 24.0 was used to analyze the basic condition of benign and malignant tumor patients and carotid atherosclerotic lesion data. The count data were analyzed by 蠂 2 test, the rate was expressed, with P0.05 as the difference was statistically significant. 2. From May 2014 to April 2017, 30 patients with oral cancer were randomly selected, including 15 cases of poorly differentiated squamous cell carcinoma, 15 cases of well-differentiated squamous cell carcinoma, and 15 cases of oral leukoplakia as control. The expression of TF (tissue factor) was detected by immunohistochemical method. The statistical software SPSS 24.0 was used to analyze the data. The difference was statistically significant. [results] the first part: 205 patients with tumor, aged 50.9 鹵12.7 years. There were 65 males and 56 females in benign tumor group. There were 54 males and 30 females in malignant tumor group. The incidence of atherosclerosis in malignant tumor group (48.8%) was significantly higher than that in benign tumor group (30.6%) (P0. 008). According to the age stratification analysis, the incidence of carotid atherosclerosis was 10.3% and 11.4% respectively between the two groups, and there was no significant difference between the two groups (P < 0. 892). The incidence of carotid atherosclerosis in malignant tumor group (69.1%) was significantly higher than that in benign tumor group (41.6%) (P < 0.023). In the second part, the expression of 1: TF in leukoplakia was lower than that in well differentiated squamous cell carcinoma and poorly differentiated squamous cell carcinoma. The difference among the three groups was statistically significant (P0. 000). [conclusion] 1. There was a correlation between maxillofacial malignant tumor and carotid atherosclerotic lesion. It is necessary for patients with malignant tumors of maxillofacial region to perform Doppler ultrasound examination of cervical blood vessels before operation, which can provide important information to prevent the occurrence of serious complications before and after operation. Tissue factor plays an important role in carotid atherosclerosis in patients with maxillofacial malignant tumor.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R739.8

【參考文獻(xiàn)】

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1 夏磊;徐格林;何曉軍;黃嘉f，

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