结膜松弛症手术切除组织中肿瘤坏死因子α刺激基因6和穿透素3表达和细胞凋亡的研究

Research on the expression of TSG-6 and PTX3 and on apoptosis in conjunctival resection tissue in conjunctivochalasis

目的研究结膜松弛症松弛结膜组织中肿瘤坏死因子仪刺激基因6（TSG-6）和穿透素3（PTX3）的表达及细胞凋亡情况。方法松弛结膜切除手术30例（32只眼）和单纯白内障超声乳化手术20例（20只眼），术中的结膜组织，制备冰冻切片；采用免疫荧光法检测结膜组织TSG-6和PTX3的表达；采用Tunel法检测结膜组织细胞凋亡情况。结果结膜松弛症结膜上皮层TSG-6呈强阳性表达（平均荧光强度76．67±26．87），较正常对照组（22．53±7．21）明显增高，差异有统计学意义（t=8．460，P〈0．001）；结膜松弛症结膜基质层及眼球筋膜囊TSG-6呈阳性表达（平均荧光强度39．25±13．24），较正常对照组（13．81±9．60）明显增高，差异有统计学意义（t=7．440，P〈0．001）；vrx3在结膜松弛症上皮层（平均荧光强度52．41±11．61）、基质层及眼球筋膜囊（平均荧光强度35．96±10．91）均呈阳性表达，较正常对照组上皮层（13．88±5．42）、基质层和眼球筋膜囊PTX3（4．47±2．49）明显增高，差异均有统计学意义（t=13．887，P〈0．001；t=12．658，P〈0．001）。结膜松弛症结膜上皮细胞凋亡率（8．64±0．13％）与正常对照组（8．33±0．11％）比较，差异无统计学意义（t=1．810，P=0．072），结膜松弛症结膜基质层及Tenon囊细胞凋亡率（40．42±0．24％）明显高于正常对照组（10．87±0．25％），差异有统计学意义（t=90．171，P〈0．001）。结论结膜松弛症松弛结膜组织中TSG-6和PTX3两种炎症相关蛋白表达明显增加，且松弛结膜组织中细胞凋亡增多，提示炎症反应及细胞凋亡参与了结膜松弛症的发病过程。

Objective To investigate the expression of TSG-6 and PTX3 as well as the apoptosis in conjunctival tissue of conjunctivochalasis （CCh）. Methods Conjunctival tissue from the conjunctival resection tissue of CCh patients and simple cataract patients were collected and then the frozen sections of eonjunctival tissue were prepared. The expressions of TSG-6 and PTX3 were detected by immunofluorescence and the apoptosis was detected by Tunel assay. Results The expression of TSG-6 was strongly positive in conjunetival epithelium of the CCh group. The average fluorescent intensity （AFI） was （76.67 ± 26.87 ） which was significantly higher than that in normal control group （ 22.53 ~ 7.21 ） and the difference was statistically significant （ t = 8.460, P 〈 0.001 ）. TSG-6 was expressed in the eonjunctival stroma and Tenon capsule of the CCh group （AFI 39.25 _± 13.24） which was higher than that in normal control group （AFI 13.81 ± 9.60） and the difference was statistically significant （t = 7. 440, P 〈 0. 001 ）. PTX3 in conjunctival epithelium （AFI 52.41 ~ ll. 61 ）, matrix and Tenon＇ s capsule （AFI 35.96 ±- 10.91 ） of the CCh group were both positive which were significantly higher than those （ AFI 13.88 ~ 5.42 and 4.47 ~ 2.49 ） in normal control group （ t = 13. 887, P 〈 0. 001 ; t = 12. 658, P 〈 0. 001 ）. No statistically significant difference was found in the apoptosis rate between CCh （8.64 ± 0. 13% ） and normal （8.33 ± 0. 11% ） eonjunctival epithelium （t = 1. 810, P = 0. 072）. The apoptosis rate was significantly increased in CCh stroma and Tenon＇ s capsule （ 40.42 ~ 0.24% ） compared with that of normal control group （ 10. 87 ±0. 25% ） （t = 90. 171, P 〈 0. 001 ）. Conclusion The expressions of TSG-6 and PTX3, as well as cell apoptosis, increase significantly in eonjunctival tissue of eonjunctivohalsis, which indicates that inflammation and apoptosis involve in the pathogenesis of conjunctivochalasis.