MMP-1、TIMP-1在唇裂术后上唇部皮肤增生性瘢痕和扁平性瘢痕组织中的表达

发布时间：2018-04-14 13:17

本文选题：唇裂 + 瘢痕　；参考：《青岛大学》2017年硕士论文

【摘要】：目的:通过对MMP-1、TIMP-1在唇裂术后上唇皮肤增生性瘢痕组织和扁平性瘢痕组织中的表达进行检测研究,探讨两者在唇裂术后不同瘢痕组织中表达的异同,进一步探索瘢痕形成机制,为唇裂修复术后减少上唇瘢痕组织的形成提供理论依据。方法:收集2015年11月至2017年1月于青岛市海慈医疗集团在口腔颌面外科单侧Ⅲ度唇裂修复术后畸形要求二次修复治疗的患者及上唇部外伤后的患者,取唇裂修复术术后二次修复中的上唇增生性瘢痕组织标本22例,扁平性瘢痕组织18例,唇部外伤需要整修所遗弃的正常皮肤皮下组织标本15例.通过HE染色观察唇裂术后上唇增生性瘢痕组织及扁平性瘢痕组织中成纤维细胞的形态、胶原排列情况;通过免疫组化染色观察各组标本中MMP-1、TIMP-1的表达程度;用专业图片处理软件Image-Pro Plus来测量每个视野区的累计光密度(IOD)和区域面积,平均光密度(AOD)是IOD/区域面积,AOD值作为MMP-1和TIMP-1的蛋白含量指标,对所得数据进行处理,取每组AOD的平均值;利用SPSS20.0对所得数据进行处理分析,取每组AOD的平均,采用单因素多组独立样本LSD-t检验,比较三组标本中MMP-1、TIMP-1的蛋白含量间差异,比较三组标本之间的MMP-1和TIMP-1的含量,判断各组标本MMP-1和TIMP-1含量之间是否存在有统计学意义的差异。结果:1.组织学上观察:(1)扁平性瘢痕组织:表皮的角质细胞层较厚,可见汗腺,毛囊等皮肤附属器,真皮层有增生的结缔组织,胶原排列较规则,少量炎细胞存在。(2)增生性瘢痕组织:表皮的角质细胞层增厚,乳头层近乎消失,真皮层中有增生的纤维结缔组织,粗大的胶原且排列紊乱,其间有增多的毛细血管;2.在上唇部正常皮肤组、扁平性瘢痕组、增生性瘢痕组中MMP-1的含量分别为0.023657±0.008477,0.040395±0.011534,0.097905±0.020593,上唇部增生性瘢痕组在三组标本中MMP-1的含量最高,上唇正常皮肤组中MMP-1的含量最低,三组之间两两比较P0.05,各组间MMP-1含量比较均具有统计学意义;3.在上唇部正常皮肤组、扁平性瘢痕组、增生性瘢痕组中TIMP-1的含量分别0.024574±0.009210,0.053827±0.015087,0.157606±0.031090,上唇部增生性瘢痕组在三组标本中MMP-1的含量最高,正常皮肤组中含量最低,三者之间两两比较P0.05,各组间比较在统计学上具有差异。结论:1.在组织结构上,唇裂术后,上唇皮肤增生性与扁平性性瘢痕组织在胶原数量及排列存在差异,两者与正常皮肤在皮肤附属器、胶原数量及排列均存在差异。2.上唇部皮肤瘢痕的形成可能受MMP-1、TIMP-1的重要调节作用;3.MMP-1、TIMP-1在唇裂术后扁平性瘢痕和增生性瘢痕中表达的变化可能是形成引起皮肤瘢痕程度不同的原因之一。
[Abstract]:Objective: to study the expression of MMP-1 and TIMP-1 in hypertrophic scar tissue and flat scar tissue of upper lip after cleft lip surgery, and to explore the differences and similarities of the expression of MMP-1 and TIMP-1 in different scar tissues after cleft lip surgery, and to explore the mechanism of scar formation.To provide a theoretical basis for the reduction of scar formation in upper lip after cleft lip repair.Methods: from November 2015 to January 2017, patients with secondary repair of deformity after unilateral third degree cleft lip repair of oral and maxillofacial surgery and patients with upper lip trauma in Qingdao Haitsi Medical Group were collected.22 cases of hypertrophic scar tissue of upper lip, 18 cases of flat scar tissue and 15 cases of normal skin tissue in need of repair after secondary repair of cleft lip were obtained.The morphology and collagen arrangement of fibroblasts in hypertrophic scar tissue and flat scar tissue of upper lip after cleft lip were observed by HE staining, and the expression of MMP-1 and TIMP-1 was observed by immunohistochemical staining.The cumulative optical density (IOD) and the area area of each visual field were measured by the professional image processing software Image-Pro Plus. The average optical density (AODD) was used as the protein content index of MMP-1 and TIMP-1, and the average optical density (AODD) was used as the protein content index of MMP-1 and TIMP-1.The average value of AOD in each group was analyzed by SPSS20.0, and the average value of AOD in each group was analyzed. The protein content of MMP-1 and TIMP-1 was compared between the three groups by LSD-t test of single factor and multiple groups of independent samples.The contents of MMP-1 and TIMP-1 were compared among the three groups, and the difference between MMP-1 and TIMP-1 in each group was statistically significant.The result is 1: 1.Histologically, the flat scar tissue: the keratinocyte layer of the epidermis is thicker, there are sweat glands, hair follicles and other skin appendages, the dermis has proliferating connective tissue, and the collagenous arrangement is more regular.A small number of inflammatory cells exist in hypertrophic scar tissue: the keratinocyte layer of the epidermis is thickened, the papillary layer is almost disappeared, there is proliferative fibrous connective tissue in the dermis, the collagen is coarse and arranged disorderly, and there are increased capillaries 2.The content of MMP-1 in normal skin group, flat scar group and hypertrophic scar group were 0.023657 卤0.008477 卤0.040395 卤0.011534 卤0.097905 卤0.020593.The MMP-1 content in the upper lip hypertrophic scar group was the highest in the three groups, and the MMP-1 content in the normal upper lip skin group was the lowest.There were significant differences in MMP-1 content among the three groups (P 0.05).The content of TIMP-1 in normal skin group, flat scar group and hypertrophic scar group were 0.024574 卤0.00921010, 0.053827 卤0.015087, 0.157606 卤0.031090, respectively. The content of MMP-1 was the highest in the upper lip hypertrophic scar group and the lowest in the normal skin group.There were statistical differences among the three groups (P 0.05).Conclusion 1.There were differences in the number and arrangement of collagen between hyperplastic and flattened scar tissues of upper lip after cleft lip surgery, and there were differences between them in the number and arrangement of collagen in skin appendages and normal skin.The formation of scar in upper lip may be regulated by MMP-1 and TIMP-1. 3. The changes of TIMP-1 expression in flat scar and hypertrophic scar after cleft lip may be one of the reasons for the different degree of skin scar.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R782.2

【参考文献】