Bax蛋白与硅油眼并发白内障发病机制的相关性研究

发布时间：2018-04-27 10:11

本文选题：硅油 + 晶状体上皮细胞　；参考：《大连医科大学》2011年硕士论文

【摘要】：目的:细胞凋亡又被称为程序性细胞死亡,是一种区别于细胞坏死的特殊细胞死亡形式,指由体内外因素触发细胞内预存的死亡程序而导致的细胞主动性死亡方式。随着凋亡与疾病关系的研究,晶状体上皮细胞凋亡和白内障的关系已引起人们的注意。近年来的研究表明,晶状体上皮细胞凋亡是除先天性白内障外各种白内障的共同细胞学基础。随着玻璃体视网膜手术技术的发展,硅油作为一种玻璃体填充物,已用于复杂性玻璃体视网膜病变并取得了令人满意的效果。硅油填充术后随访中,白内障作为硅油填充眼最常见的并发症,其发生率几乎高达100%。白内障的发展不仅可以使患者的视力再次下降,而且影响了眼底检查,并可能延误眼底病的诊治,因此硅油填充眼并发白内障的发生、发展已越来越受到眼科医生们的重视,但硅油引起白内障的发病机制目前尚未明确。本课题通过观察Bax蛋白在硅油眼并发白内障晶状体上皮细胞上的表达及作用,探讨晶状体上皮细胞凋亡与硅油眼并发障的相关性及硅油引起白内障的发病机制。方法:收集45例不同类型病人的晶状体前囊膜,其中包括老年性白内障患者20例20眼,硅油眼并发白内障患者18例18眼,健康成人各种原因导致的晶状体脱位患者7例7眼,通过HE染色及免疫组化的方法观察Bax蛋白在老年性白内障、硅油眼并发白内障及晶状体脱位患者的晶状体上皮细胞中的表达情况。结果: 1.光镜下各组晶状体上皮细胞的形态:晶状体脱位的晶状体上皮细胞分布均匀,大小一致,细胞间相互嵌合,细胞核呈圆形,大小均匀一致;老年性白内障晶状体上皮细胞较晶状体脱位的晶体上皮细胞体积变小,前囊膜皱缩,形态极其不规则,与囊膜分离,存在细胞肿大,细胞间隙加大,细胞核大小不一致及细胞重叠的现象;硅油眼并发白内障可见前囊膜卷曲,晶状体上皮变性、纤维化生、增生,细胞形态各异,多呈扁椭圆形或椭圆形,排列紊乱,细胞间隙扩大,部分前囊膜下细胞基质中见硅油小滴。 2.采用免疫组化技术检测bax蛋白在各组晶状体上皮细胞中的表达:bax蛋白在老年性白内障及硅油眼并发白内障晶状体上皮细胞中有表达,在晶状体脱位晶状体上皮细胞中无表达,三组之间bax蛋白表达有显著性差异(P〈0.05),且三组中两两之间亦存在统计学差异(P〈0.05)。bax蛋白在硅油眼并发白内障晶状体上皮细胞的表达强于老年性白内障晶状体上皮细胞的表达,二者之间存在统计学差异(P〈0.05)。结论:Bax蛋白与硅油眼并发白内障的发生、发展存在相关性;老年性白内障及硅油眼并发白内障的发生可能与其晶状体上皮细胞凋亡有相关性,但二者的发病机制可能存在差异。
[Abstract]:Objective: apoptosis, also known as programmed cell death, is a special form of cell death, which is different from cell necrosis. With the study of the relationship between apoptosis and disease, the relationship between lens epithelial cell apoptosis and cataract has attracted people's attention. Recent studies have shown that lens epithelial cell apoptosis is the common cytological basis of cataract except congenital cataract. With the development of vitreoretinal surgery, silicone oil, as a kind of vitreous filler, has been used in complicated vitreoretinopathy with satisfactory results. Cataract is the most common complication of silicone oil-filled eyes. The development of cataract can not only decrease the visual acuity of the patients again, but also affect the fundus examination, and may delay the diagnosis and treatment of fundus disease. Therefore, the occurrence of cataract in silicone oil filled eyes has been paid more and more attention by ophthalmologists. However, the pathogenesis of cataract caused by silicone oil is not clear. In this study, we observed the expression and role of Bax protein in lens epithelial cells of silicone oil eyes complicated with cataract, and discussed the relationship between apoptosis of lens epithelial cells and complicated barrier of silicone oil eyes and the pathogenesis of cataract induced by silicone oil. Methods: the anterior capsule of lens was collected from 45 patients of different types, including 20 cases of senile cataract (20 eyes), 18 eyes of silicone eye (18 cases) with cataract, 7 cases (7 eyes) of lens dislocation caused by various causes in healthy adults. The expression of Bax protein in lens epithelial cells of senile cataract, silicone oil eye complicated cataract and lens dislocation was observed by HE staining and immunohistochemistry. Results: 1. The morphology of lens epithelial cells in each group under light microscope: the lens epithelial cells of lens dislocation were evenly distributed and uniform in size, intercellular chimera, round nucleus and uniform size. The volume of lens epithelial cells in senile cataract is smaller than that in lens dislocation, the anterior capsule shrinks, the shape is extremely irregular, the cells are enlarged and the intercellular space is enlarged. In silicone oil eyes, the anterior capsule curl, lens epithelium degeneration, fibrogenesis, proliferation, cell shape are different, most of them are flat ellipse or ellipse, and the arrangement is disordered. The intercellular space was enlarged and a small drop of silicon oil was found in the matrix of some subcapsular cells. 2. The expression of bax protein in lens epithelial cells was detected by immunohistochemical technique. The expression of bax protein was detected in the lens epithelial cells of senile cataract and silicone eye complicated with cataract, but not in the lens epithelial cells of lens dislocation. There was significant difference in the expression of bax protein among the three groups (P < 0.05), and there was also a significant difference in the expression of P < 0.05).bax protein between the two groups. The expression of P < 0.05).bax protein in the lens epithelial cells of silicone oil eyes complicated with cataract was stronger than that in the lens epithelial cells of senile cataract. There was statistical difference between the two groups (P < 0.05). Conclusion there is a correlation between the protein of 10% Bax and the occurrence and development of cataract in silicone oil eyes, and the occurrence of senile cataract and cataract complicated with silicone oil eye may be related to the apoptosis of lens epithelial cells, but the pathogenesis of them may be different.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R776.1

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