复发性阿弗他溃疡伴肥胖患者高胰岛素抵抗的临床研究

发布时间：2018-03-06 19:47

本文选题：复发性阿弗他溃疡　切入点：胰岛素抵抗　出处：《山西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:本研究通过检测复发性阿弗他溃疡(Recurrent aphthous ulcers,RAU)伴肥胖(Obese,OB)患者、单纯RAU或OB患者与健康人的血清胰岛素抵抗(Insulin resistance,IR)情况及肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)的表达水平,分析RAU对肥胖个体IR情况的影响及与TNF-α的相关性,为指导RAU患者进行IR的早期筛查、诊断和干预,以预防前期糖尿病的发生并延缓其向糖尿病的转化提供参考依据。方法:本研究随机选择了于2015年11月至2016年12月在山西医科大学第一医院口腔科门诊就诊并被确诊为轻型RAU的40例患者,根据身体质量指数分为RAU伴肥胖组(20例)和RAU组(20例);并选择同期就诊于山西医科大学第一医院体检中心既往无RAU病史的40例志愿者,根据身体质量指数分为肥胖组(20例)和对照组(20例)。四组分别应用美国贝克曼库尔特公司生产的AU5821系列全自动生化分析仪使用已糖激酶法检测血清中空腹血糖含量,中国科大创新有限公司生产的GC-1200γ放射免疫计数器使用放射免疫法检测血清中空腹胰岛素含量,并通过公式计算得出胰岛素抵抗指数HOMA-IR分值,采用美国分子仪器公司生产的连续波长酶标仪使用酶联免疫吸附法(ELISA)检测血清中TNF-α含量。由同一名口腔科医师对患者进行口腔黏膜检查并记录RAU发作的部位、大小及数目。收集并记录四组个人资料包括年龄,性别,身高,体重及既往病史以及检测、计算所得数据。采用SPSS22.0统计分析软件根据实验数据行统计学分析,并认为P0.05时结果有统计学差异。结果:1.TNF-α含量RAU+OB组高于RAU组和OB组(P0.05,P0.05);RAU组和OB组高于对照组(P0.05,P0.05)。RAU与OB均可作为主效应影响TNF-α含量(P0.05,P0.05),且两者具有相互协同作用(P0.05)。2.空腹血糖浓度RAU+OB组高于RAU组(P0.05);RAU+OB组高于OB组(P0.05);RAU组和OB组高于对照组(P0.05,P0.05);RAU可作为主效应影响血糖浓度(P0.05),OB对血糖浓度无明显影响(P0.05),两者无明显交互作用(P0.05)。3.空腹胰岛素浓度RAU+OB组高于RAU组和OB组(P0.05,P0.05);RAU组和OB组高于对照组(P0.05,P0.05)。RAU与OB均可作为主效应影响胰岛素浓度(P0.05,P0.05),但两者无明显交互作用(P0.05)。4.HOMA-IR值RAU+OB组高于RAU组和OB组(P0.05,P0.05);RAU组和OB组高于对照组(P0.05,P0.05)。RAU与OB均可作为主效应影响HOMA-IR值(P0.05,P0.05),但两者无明显交互作用(P0.05)。5.相关性分析显示,血清TNF-α含量与HOMA-IR分值呈正相关性(P0.05)。结论:1.RAU患者处于活动期时可能存在机体血清TNF-α、IR表达水平升高的现象,在肥胖个体更加明显。2.RAU患者处于活动期时可能存在机体血清空腹血糖浓度升高的现象。3.血清TNF-α表达水平与胰岛素抵抗指数呈正相关。
[Abstract]:Objective: to investigate the serum insulin resistance of patients with recurrent aphthous ulcersrau (Rau), simple RAU or OB and healthy subjects, and the expression of tumor necrosis factor- 伪 Tumor necrosis factor- 伪 (TNF- 伪). To analyze the influence of RAU on IR in obese individuals and its correlation with TNF- 伪, to guide the early screening, diagnosis and intervention of IR in RAU patients. Methods: in order to prevent the occurrence of prediabetes mellitus and delay its transformation into diabetes mellitus. Methods: this study randomly selected from November 2015 to December 2016 in the Department of Stomatology of the first Hospital of Shanxi Medical University, and was treated by the Department of Stomatology. 40 patients diagnosed as mild RAU, According to body mass index (BMI), 20 cases of RAU with obesity) and 20 cases of RAU group were divided into two groups, and 40 volunteers who had no history of RAU in the physical examination Center of the first Hospital of Shanxi Medical University were selected at the same time. According to body mass index (BMI), 20 patients were divided into obese group (n = 20) and control group (n = 20). AU5821 series automatic biochemical analyzer produced by Beckman Kurt Company of USA was used to detect fasting blood glucose in serum by hexokinase method. The GC-1200 纬 RIA counter produced by China University of Science and Technology Innovation Co., Ltd. uses radioimmunoassay to detect fasting insulin content in serum, and calculates the HOMA-IR score of insulin resistance index by formula. The serum TNF- 伪 level was detected by Elisa with the continuous wavelength enzymatic marker produced by American Molecular Instruments. The oral mucosa of the patient was examined by the same stomatologist and the site of RAU attack was recorded. Size and number. Four groups of personal data including age, sex, height, weight and past medical history were collected and recorded. The data were calculated and analyzed by SPSS22.0 statistical analysis software according to the experimental data. Results 1. The content of TNF- 伪 in RAU OB group was higher than that in RAU group and OB group. The concentration of glucose in RAU OB group was higher than that in RAU group (P 0.05) and that in OB group was higher than that in OB group (P 0.05) and in OB group was higher than that in control group (P 0.05) and P 0.05% Rau could be regarded as a main effect on blood glucose concentration. There was no significant effect of the two groups on blood glucose concentration. There was no significant interaction between the two groups in fasting insulin concentration (RAU). OB group is higher than RAU group and OB group P0.05P0.05P0.05RU group and OB group are higher than control group P0.05P0.05U. Rau and OB can affect insulin concentration as main effect, but there is no obvious interaction between them. HOMA-IR value of RAU OB group is higher than that of RAU group and OB group P0.05P0.05rau group and OB group is higher than control group P0.05P0.05ru group and OB group is higher than control group P0.05P0.05ru group and OB group is higher than control group P0.05P0.05ru group and OB group is higher than control group P0.05P0.05ru group and OB group is higher than control group P0.05P0.05P0.05ru group and OB group. Both OB and OB can affect the HOMA-IR value as the main effect, but there is no obvious interaction between them. The correlation analysis shows that, There was a positive correlation between serum TNF- 伪 content and HOMA-IR score (P 0.05). Conclusion: 1. The expression of TNF- 伪 IR in serum may increase in the active stage of patients with Rau. In obese individuals, it is more obvious that the serum fasting blood glucose level may be increased when the patients with RAU are in active phase. The expression of TNF- 伪 in serum is positively correlated with the insulin resistance index.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R781.5;R589.2

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