先天性血管瘤激光治疗前后ICAM-1的表达及意义

发布时间：2018-05-03 13:09

  本文选题：细胞间粘附分子-1 + 先天性血管瘤　； 参考：《桂林医学院》2012年硕士论文

【摘要】：目的：通过对婴幼儿增生期先天性血管瘤激光治疗前后的临床表现及血管瘤组织病理形态学特点的观察,以及测定治疗前后患儿血清中sICAM-1和组织中mICAM-1的情况,探讨：①ICAM-1在诊断婴幼儿先天性血管瘤是否处于增生期中的临床意义。②长脉宽1064nmNd:YAG激光治疗婴幼儿先天性血管瘤的临床疗效。方法：研究对象为2010年8月-2011年8月到桂林医学院附属医院皮肤科激光美容门诊就诊的12个月内的增生期先天性血管瘤患儿50例。1.所有患儿给予可调长脉宽1064nm Nd:YAG激光治疗2次,1次/4周,随访和记录患儿治疗前及治疗后4周的临床观察数据。2.激光治疗前及治疗4周后运用ELISA方法及免疫组化方法测定血清中sICAM-1和组织中mICAM-1的水平,并分别与正常血清对照组和正常组织对照组比较。结果：1.50例血管瘤患儿激光治疗8周后,临床疗效情况如下：Ⅰ级4例(8%),Ⅱ级19例(38%),Ⅲ级20例(40%),Ⅳ级7例(14%)。其中,6个月内的患儿26例： Ⅰ级1例(3.85%),Ⅱ级9例(34.62%),Ⅲ级12例(46.15%),Ⅳ级4例(15.38%)；大于6个月的患儿24例： Ⅰ级3例(12.5%),Ⅱ级10例(41.67%),Ⅲ级8例(33.33%),Ⅳ级3例(12.5%)。两组患儿疗效比较差异有显著性(P0.05)。2.50例血管瘤患儿治疗前血清中的sICAM-1为(622.03±71.91)μ g/L,正常血清组sICAM-1为(197.29±38.87)μ g/L,两者比较差异有显著性(P0.01)；激光治疗后4周患儿血清sICAM-1为(597.32±81.60)μ g/L,与正常对照组比较,差异有显著性(P0.01)；治疗前与治疗后4周比较,差异有显著性(P0.05)。3.50例血管瘤患儿治疗前瘤体组织mICAM-1的表达显著强于激光治疗后4周及正常组织对照组(P0.01)；治疗4周后组织mICAM-1的表达结果比治疗前减弱,差异有显著性(P0.05)。结论：1.ICAM-1在先天性血管瘤的表达与血管的增生和密度有关,血管瘤增生期表达增高,激光干预致血管瘤消退后呈现下降趋势,提示ICAM-1可能与血管瘤的增生活性有关。2.婴幼儿先天性血管瘤患儿经激光治疗前后,血清sICAM-1和瘤体组织中mICAM-1的变化趋势一致,提示检测外周血sICAM-1的水平可以反映血管瘤组织中mICAM-1的表达水平。3.sICAM-1可能是判断血管瘤患儿是否处于增生期以及疗效判定的辅助检测指标之一。4.长脉宽1064nmNd:YAG激光治疗增生期婴幼儿先天性血管瘤疗效确切,副作用少,方法可靠。5.年龄6个月内的血管瘤患儿激光治疗效果优于年龄大于6个月的患儿,提示对于先天性血管瘤应及早进行临床干预,以期获得更好的临床效果。
[Abstract]:Objective: to observe the clinical manifestations and histopathological features of congenital hemangioma in children with hyperplastic phase before and after laser treatment, and to determine the sICAM-1 in serum and mICAM-1 in tissues before and after treatment. To investigate the clinical significance of the diagnosis of infantile congenital hemangioma with 1: 1 ICAM-1. 2 the clinical effect of long pulse width 1064nmNd:YAG laser in the treatment of infantile congenital hemangioma. Methods: from August 2010 to August 2011, 50 children with hyperplastic congenital hemangioma were enrolled in the Department of Dermatology, Department of Dermatology, affiliated Hospital of Guilin Medical College. All the children were treated with adjustable pulse width 1064nm Nd:YAG laser for 2 times / 4 weeks. The clinical observation data before and after treatment were recorded and followed up. 2. 2. The levels of sICAM-1 in serum and mICAM-1 in tissues were determined by ELISA and immunohistochemistry before and 4 weeks after laser therapy and were compared with those in normal serum and normal tissue control groups. Results after 8 weeks of laser treatment in 1.50 children with hemangioma, the clinical results were as follows: grade 鈪，

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