类胰蛋白酶和IgE诊断过敏性休克的实验研究和法医学意义

发布时间：2018-01-31 05:52

本文关键词： 过敏性休克类胰蛋白酶 IgE 肥大细胞免疫组化　出处：《山西医科大学》2004年硕士论文　论文类型：学位论文

【摘要】：目的：过敏性休克在临床医学实践中颇为常见，它是由于特异性过敏原作用于致敏病人而引起的以循环衰竭为主的速发型变态反应。它发病急剧，难以预见，死亡率较高。极易引起医疗纠纷等一系列法律问题，且一般常规尸检无特异性病理变化，所以过敏性休克一直是法医学鉴定中的一大难题。本实验试图寻找诊断过敏性休克的敏感、客观指标。方法：18只体重200克左右的豚鼠，随机分为实验组和对照组（每组各9只）。建立多人血清致敏的豚鼠过敏性休克动物模型，留取豚鼠血清、呼吸道及消化道组织，（1）应用放射免疫学及酶免疫荧光方法，对血清中IgE和类胰蛋白酶水平进行检测；（2）对呼吸道、消化道组织进行IgE免疫组化的方法染色。结果：试验组与对照组相比，（1）血清IgE水平显著升高（实验组1.56±0.31IU/ML，，对照组0.64±2.53 IU/ML，p＜0.01＝，血清类胰蛋白酶水平显著增高（实验组　1.86±0.24ng/ml，对照组0.518±0.16ng/ml，p＜0.01＝；（2）呼吸道及消化道粘膜IgE免疫组化染色阳性率增高（p0.01）。结论：与对照组比较，过敏性休克时，（1）血清IgE水平及类胰蛋白酶水平增高；（2）IgE免疫组化发现实验组表达显著增高。因此，通过放射免疫及酶免疫荧光法检测血清IgE和类胰蛋白酶水平，并结合免疫组化法检测咽喉、肺及胃肠组织的IgE，可以辅助诊断过敏性休克。
[Abstract]:Objective: anaphylactic shock is quite common in clinical practice. It is a rapid allergic reaction mainly caused by circulatory failure caused by specific allergen in sensitized patients. The onset of anaphylactic shock is rapid and unpredictable. The mortality rate is high. It is easy to cause a series of legal problems, such as medical disputes, and general routine autopsy has no specific pathological changes. Therefore, anaphylactic shock has always been a difficult problem in forensic identification. This experiment attempts to find sensitive and objective indicators for the diagnosis of anaphylactic shock. Methods Twenty eight guinea pigs weighing about 200 g were randomly divided into experimental group and control group (9 guinea pigs in each group). The levels of IgE and trypsin in serum were detected by radioimmunoassay and enzyme immunofluorescence. 2) IgE immunohistochemical staining was performed on the respiratory and digestive tract tissues. Results: compared with the control group, the serum IgE level in the experimental group was significantly higher than that in the control group (1.56 卤0.31 IUU / MLand 0.64 卤2.53 IU/ML in the control group). P < 0.01, serum trypsin level increased significantly (experimental group 1.86 卤0.24ng / ml, control group 0.518 卤0.16ng / ml < 0.01g / ml); 2) the positive rate of IgE immunohistochemical staining in the mucous membrane of the respiratory tract and digestive tract was higher than that in the control group (P 0.01). Conclusion: compared with the control group, the serum levels of IgE and trypsin in anaphylactic shock patients were higher than those in the control group. The expression of IgE and trypsin in serum were detected by radioimmunoassay and enzyme-immunofluorescence assay, and the pharynx and larynx were detected by immunohistochemistry. IgE in lung and gastrointestinal tissues can assist in the diagnosis of anaphylactic shock.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2004
【分类号】：D919

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