IL-10在下肢静脉性溃疡中的表达及意义
发布时间：2018-08-14 12:09
【摘要】：目的:本研究通过搜集单纯浅静脉曲张及深静脉血栓后遗症患者溃烂的皮肤组织,以免疫组织化学的方法检测白介素-10(Interleukin-10,IL-10)在其中的表达,探讨IL-10与静脉性溃疡之间的关系及不同原因形成的静脉性溃疡在发病机制上是否存在差异。比较手术前后下肢溃疡皮肤中IL-10的表达,研究双下肢大隐静脉高位结扎+曲张静脉剥脱+交通支血管缝扎术在治疗下肢静脉性溃疡中的治疗效果,从而为临床治疗静脉性溃疡提供理论依据。方法:收集25例在我院接受治疗的单纯性下肢静脉曲张及21例下肢深静脉血栓后遗症(Post-thrombotic syndrome,PTS)患者溃疡皮肤组织,所有患者均行下肢深静脉顺行造影以了解深静脉瓣膜功能及血管通畅的情况,并排除动脉缺血、糖尿病、感染、淋巴肿及其他自身免疫性疾病。所有患者患肢病变的大隐静脉均给予剥脱,局部曲张病变血管给予切除,溃疡处给予缝扎,术后均给予血管活性药物应用,未使用抗生素。将所取标本分为三组,即正常皮肤组、术前溃疡组和术后溃疡组,术中取溃疡区域四周的皮肤组织作为溃疡组,浅静脉高位结扎开口处周围正常皮肤作为正常对照组,术后一周取溃疡周围皮肤作为术后溃疡标本。采用免疫组化的方法来测定各组组织标本中IL-10的表达。每个组织切片都在高倍镜下随机选取3个视野进行观察,每个视野中查看100个细胞,当所取组织细胞质中出现棕色时,即判定这个细胞的表达为阳性,按此标准,记录每个视野中呈阳性表达的细胞数量,同时计算出阳性表达率,每组切片取三个视野平均值。所有数据以均值±标准差(`x±S)来表示,数据分析SPSS17.0来处理,两两比较用t检验,设显著性检验水准为α=0.05,P〈0.05视为有显著性差异。结果:经统计学分析,阳性表达的IL-10细胞在术前溃疡组织中比正常皮肤要显著增加(P〈0.05);术后一周患者愈合中的溃疡组织IL-10的表达要比术前明显降低(P0.05);单纯浅静脉曲张患者溃疡皮肤组织中IL-10的表达与PTS无显著性差异。术前溃疡皮肤组织中可见大量胞质或胞膜被染成棕色的细胞,着色较深,呈局灶性分布,主要位于真皮层。其中溃疡组标本的皮肤真皮层中存在了炎性物质的聚集,新生的血管较正常组皮肤明显增多。另外,正常皮肤组的标本中同样散见阳性表达的细胞,数量稀少,且染色浅淡。结论:1.IL-10在静脉性溃疡患者皮肤组织中的表达较正常皮肤明显升高,说明IL-10与静脉性溃疡的发病机制有密切关系。2.IL-10在单纯大隐静脉曲张和PTS患者溃疡皮肤组织中的表达无显著差异,说明二者在发病机制上相似。3.双下肢大隐静脉高位结扎+曲张静脉剥脱+交通支静脉结扎术可以使下肢静脉性溃疡患者皮肤组织中IL-10的表达降低,因此可以用IL-10作为评判术后疗效的指标。
[Abstract]:Objective: to investigate the expression of interleukin-10 (IL-10) in patients with superficial varices and deep venous thrombosis sequelae by immunohistochemical method. To explore the relationship between IL-10 and venous ulcers and whether there are differences in pathogenesis of venous ulcers caused by different causes. To compare the expression of IL-10 in the skin of lower extremity ulcer before and after operation, and to study the effect of high ligation of varicose vein of lower extremity on the treatment of venous ulcer of lower extremity. So as to provide a theoretical basis for clinical treatment of venous ulcer. Methods: the skin tissues of 25 patients with simple varices of lower extremity and 21 patients with Post-thrombotic syndrome were collected. All patients underwent anterograde deep vein angiography to understand the valvular function and patency of the deep vein, and to exclude arterial ischemia, diabetes, infection, lymphadenoma and other autoimmune diseases. All patients were treated with exfoliation of saphenous vein, resection of local varicose vessels, suture ligation of ulcer, and vasoactive drugs without antibiotics. The specimens were divided into three groups: normal skin group, preoperative ulcer group and postoperative ulcer group. The skin tissue around the ulcer area was taken as the ulcer group during the operation, and the normal skin around the opening of high ligation of superficial vein was taken as the normal control group. The skin around the ulcer was taken as the ulcer specimen one week after operation. Immunohistochemical method was used to detect the expression of IL-10 in tissues of each group. Each tissue section was randomly selected for observation under a high-power microscope. 100 cells were examined in each field. When brown appeared in the cytoplasm of the tissue, the positive expression of the cell was determined, according to this criterion. The number of positive cells in each field was recorded and the positive expression rate was calculated. All the data were expressed as mean 卤standard deviation (`x 卤S), the data were analyzed by SPSS17.0, and compared with each other by t test, the significant test level was set as 伪 0. 05% (P < 0. 05) and the difference was significant (P < 0. 05). Results: by statistical analysis, The positive expression of IL-10 cells in the ulcer tissue was significantly higher than that in the normal skin tissue (P < 0. 05), the expression of IL-10 in the ulcer tissue was significantly lower than that in the preoperation group (P0.05), and the expression of IL-10 in the ulcer skin group of the patients with superficial varicose vein was significantly lower than that in the patients with superficial varicose vein. There was no significant difference between the expression of IL-10 and PTS in weaving. A large number of brown cells were found in the skin tissue of ulcers before operation, which were stained with dark and focal distribution, mainly located in the dermis. In the ulcer group, inflammatory substances were accumulated in the dermis, and the neovascularization was significantly higher than that in the normal skin. In addition, positive cells were also scattered in normal skin group. Conclusion 1. The expression of IL-10 in the skin of patients with venous ulcer was significantly higher than that in normal skin. 2. There was no significant difference in the expression of IL-10 in the skin tissues of patients with varicose great saphenous vein and PTS, which indicated that the pathogenesis of venous ulcer was similar to that of IL-10. The high ligation of varicose vein in both lower extremities can reduce the expression of IL-10 in the skin tissue of patients with venous ulcer of lower extremity, so IL-10 can be used as an index to evaluate the curative effect after operation.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R654.4
本文编号：2182817
[Abstract]:Objective: to investigate the expression of interleukin-10 (IL-10) in patients with superficial varices and deep venous thrombosis sequelae by immunohistochemical method. To explore the relationship between IL-10 and venous ulcers and whether there are differences in pathogenesis of venous ulcers caused by different causes. To compare the expression of IL-10 in the skin of lower extremity ulcer before and after operation, and to study the effect of high ligation of varicose vein of lower extremity on the treatment of venous ulcer of lower extremity. So as to provide a theoretical basis for clinical treatment of venous ulcer. Methods: the skin tissues of 25 patients with simple varices of lower extremity and 21 patients with Post-thrombotic syndrome were collected. All patients underwent anterograde deep vein angiography to understand the valvular function and patency of the deep vein, and to exclude arterial ischemia, diabetes, infection, lymphadenoma and other autoimmune diseases. All patients were treated with exfoliation of saphenous vein, resection of local varicose vessels, suture ligation of ulcer, and vasoactive drugs without antibiotics. The specimens were divided into three groups: normal skin group, preoperative ulcer group and postoperative ulcer group. The skin tissue around the ulcer area was taken as the ulcer group during the operation, and the normal skin around the opening of high ligation of superficial vein was taken as the normal control group. The skin around the ulcer was taken as the ulcer specimen one week after operation. Immunohistochemical method was used to detect the expression of IL-10 in tissues of each group. Each tissue section was randomly selected for observation under a high-power microscope. 100 cells were examined in each field. When brown appeared in the cytoplasm of the tissue, the positive expression of the cell was determined, according to this criterion. The number of positive cells in each field was recorded and the positive expression rate was calculated. All the data were expressed as mean 卤standard deviation (`x 卤S), the data were analyzed by SPSS17.0, and compared with each other by t test, the significant test level was set as 伪 0. 05% (P < 0. 05) and the difference was significant (P < 0. 05). Results: by statistical analysis, The positive expression of IL-10 cells in the ulcer tissue was significantly higher than that in the normal skin tissue (P < 0. 05), the expression of IL-10 in the ulcer tissue was significantly lower than that in the preoperation group (P0.05), and the expression of IL-10 in the ulcer skin group of the patients with superficial varicose vein was significantly lower than that in the patients with superficial varicose vein. There was no significant difference between the expression of IL-10 and PTS in weaving. A large number of brown cells were found in the skin tissue of ulcers before operation, which were stained with dark and focal distribution, mainly located in the dermis. In the ulcer group, inflammatory substances were accumulated in the dermis, and the neovascularization was significantly higher than that in the normal skin. In addition, positive cells were also scattered in normal skin group. Conclusion 1. The expression of IL-10 in the skin of patients with venous ulcer was significantly higher than that in normal skin. 2. There was no significant difference in the expression of IL-10 in the skin tissues of patients with varicose great saphenous vein and PTS, which indicated that the pathogenesis of venous ulcer was similar to that of IL-10. The high ligation of varicose vein in both lower extremities can reduce the expression of IL-10 in the skin tissue of patients with venous ulcer of lower extremity, so IL-10 can be used as an index to evaluate the curative effect after operation.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R654.4
【共引文献】
相关期刊论文 前2条
1 赵为国;吴良平;戴晓江;王俊;;下肢静脉性溃疡的微创治疗[J];江西医学院学报;2009年07期
2 陆黎;邹君杰;章希炜;;胱抑素C水平与下肢静脉性溃疡发生的相关性研究[J];南京医科大学学报(自然科学版);2012年07期
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