TGF-β2、Ⅰ型胶原在PVR、PDR患者增生膜中的表达和意义

发布时间：2018-02-02 00:35

本文关键词： 转化生长因子-β2 I型胶原增生性玻璃体视网膜病变增生性糖尿病视网膜病变免疫组化法　出处：《郑州大学》2014年硕士论文　论文类型：学位论文

【摘要】：增生性玻璃体视网膜病变（proliferative viteroretinopathy，PVR）、增生性糖尿病视网膜病变（proliferative diabetic retinopathy，PDR）是临床上常见的两种眼内纤维增生性疾病，具有难以治愈，预后较差等特点，使患者的视力严重下降，甚至失明。PVR、PDR具有相似的病理特征，共同点是在视网膜前形成纤维增生膜和在视网膜下形成纤维条索，收缩、牵拉引起视网膜脱离，使它们在临床上治疗起来相当棘手。但是二者也有不同点，其本质的区别在于PDR增生膜内有新生血管的形成而PVR增生膜内无新生血管。以往的研究认为转化生长因子β2（transforming growth factor-β2，TGF-β2）和I型胶原参与了细胞外基质和新生血管的形成。测定TGF-β2和I型胶原在PVR、PDR患者视网膜前的增生膜中的表达情况及这两种蛋白之间的关系有助于进一步了解这两种疾病的形成机制。目的通过检测TGF-β2，I型胶原在PVR、PDR患者增生膜中的表达情况及这两种蛋白之间的关系，探讨其在PVR、PDR发生中的作用及机制。方法利用HE染色及免疫组化法（immunohistochemistry，IHC）对PDR、PVR/C级和PVR/D级患者玻璃体切除术中所取的增生膜进行染色及对TGF-β2、I型胶原进行检测，其中对照组6例6眼，PVR组24例24眼，其中PVR/C级组13例13眼，PVR/D级组11例11眼，PDR组12例12眼。结果 HE染色结果示：两种增生膜中均由成纤维细胞、上皮细胞及胶原纤维束等组成，光学显微镜下观察免疫组化染色结果示：TGF-β2和I型胶原在对照组中很少见，TGF-β2主要在PVR、PDR增生膜内增生细胞的胞浆和细胞膜表面表达，I型胶原主要在增生膜的细胞外基质中表达。采用Biosens Digital ImagingAnalysis Systems分析系统对图像中阳性表达部位分析得出：TGF-β2、I型胶原平均灰度值分别为(均数±标准差)：对照组：54.62±8.37，63.32±7.81；PVR/C级组：178.25±11.30，198.74±16.23；PVR/D级组：229.17±14.25，287.33±9.78；PVR组（PVR/C级组和PVR/D级组）：203.71±12.24，243.04±13.05；PDR组：203.84±7.82，247.81±11.17。应用SPSS17.0分析软件进行统计分析，先行方差齐性检验，，再行多组间两两比较的LSD-t检验及Spearson相关分析，以P0.05为差异有统计学意义。PVR/C级组、PVR/D级组及PDR组中TGF-β2、I型胶原的平均灰度明显高于对照组(P0.05)，PVR/D组中TGF-β2、I型胶原的平均灰度显著高于PVR/C组(P0.05)，PDR组TGF-β2、I型胶原的平均灰度和PVR组相比无统计学差异（P0.05），经相关性分析得出：PVR、PDR患者增生膜中TGF-β2和I型胶原的表达具有关联性（r=0.775，P0.05）。结论 1．TGF-β2、I型胶原共同参与了PVR、PDR增生膜的形成； 2．随着PVR的进展，TGF-β2、I型胶原在增生膜中的表达呈上升趋势且二者的表达具有强相关性；
[Abstract]:Proliferative vitreoretinopathy (PVR). Proliferative diabetic retinopathy (PDR) is a common intraocular fibroproliferative disease. With the characteristics of difficult to cure and poor prognosis, the visual acuity of the patients was seriously decreased, even blindness. PVR PDR had similar pathological characteristics. The common denominator is the formation of fibrous proliferative membrane before the retina and the formation of the fibrous cord under the retina, which causes retinal detachment due to contraction and pulling, which makes them very difficult to treat clinically. However, there are also differences between the two. The essential difference lies in the formation of neovascularization in the proliferative membrane of PDR and the absence of neovascularization in the proliferative membrane of PVR. Transforming growth factor- 尾 2. TGF- 尾 2) and type I collagen were involved in the formation of extracellular matrix and neovascularization. TGF- 尾 2 and type I collagen were measured in PVR. The expression of preretinal proliferative membrane and the relationship between these two proteins in PDR patients are helpful to further understand the formation mechanism of these two diseases. Purpose By detecting the expression of TGF- 尾 _ 2 type I collagen in the proliferative membrane of patients with PVR, and the relationship between these two proteins, the role and mechanism of TGF- 尾 _ 2 I collagen in the pathogenesis of PDR of PVR were investigated. Method PDR was treated with HE staining and immunohistochemical method. The proliferative membranes of PVR/C and PVR/D grade patients were stained and the type I collagen of TGF- 尾 2 was detected in 6 cases and 6 eyes in the control group. There were 24 cases (24 eyes) in PVR group, including 13 cases (13 eyes) in PVR/C grade group (13 eyes), 11 cases (11 eyes) in PVR/C grade D group (11 eyes) and 12 eyes (12 eyes) in PVR/C group. Results The results of HE staining showed that the two proliferative membranes were composed of fibroblasts, epithelial cells and collagenous bundles. The immunohistochemical staining under optical microscope showed that TGF- 尾 2 and collagen I were rare in the control group. TGF- 尾 2 was mainly found in PVR. The expression of cytoplasm and cell membrane surface of proliferative cells in PDR proliferative membrane. Type I collagen was mainly expressed in extracellular matrix of proliferative membrane. Biosens Digital ImagingAnalysis was used. The Systems analysis system analyzed the positive expression of TGF- 尾 2 in the image. The average gray values of type I collagen were (mean 卤standard deviation): control group: 54.62 卤8.37 卤63.32 卤7.81; PVR/C group: 178.25 卤11.30 卤198.74 卤16.23; PVR/D group: 229.17 卤14.25 + 287.33 卤9.78; PVR group: PVR / C group and PVR/D group: W 203.71 卤12.24 卤243.04 卤13.05; PDR group: 203.84 卤7.82 卤247.81 卤11.17.The statistical analysis was carried out with SPSS17.0 software, and the homogeneity of variance was tested first. The LSD-t test and Spearson correlation analysis of pairwise comparison between the two groups were carried out again, with P0.05 as the difference. There was statistical significance in the PVR / C group. The average grayscale of TGF- 尾 _ 2 type I collagen in PVR/D group and PDR group was significantly higher than that in control group (P 0.05). The average grayscale of type I collagen was significantly higher than that of PVR/C group (P 0.05). There was no significant difference between PVR group and PVR group (P 0.05). The correlation analysis showed that the expression of TGF- 尾 2 and type I collagen in the proliferative membrane of the patients with PDR was correlated with the expression of TGF- 尾 2 and type I collagen. Conclusion 1. Type I collagen of TGF- 尾 2 was involved in the formation of PDR proliferative membrane of PVR. 2. With the development of PVR, the expression of TGF- 尾 _ 2 I collagen in proliferative membrane showed an upward trend, and the expression of TGF- 尾 _ 2 I collagen was strongly related to the expression of TGF- 尾 _ (2) I collagen.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R774.1

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