新生肺透明膜病患儿表面活性蛋白及甲状腺转录因子的表达及其临床价值-东南大学学报医学版

新生肺透明膜病患儿表面活性蛋白及甲状腺转录因子的表达及其临床价值

单位：1. 海口市妇幼保健院新生儿科, 海南海口 570203;
2. 海南医学院病理生理实验室, 海南海口 571100

分类号：R722.13

出版年·卷·期（页码）：2019·38·第一期（154-158）

摘要：

目的：分析新生肺透明膜病患儿表面活性蛋白B及甲状腺转录因子的表达，研究其临床价值。方法：选取我院2016年7月至2017年5月新生肺透明膜病患儿57例，按尸检档案分为膜病组35例，对照组22例，进行免疫组织化学染色用SP法。检测表明活性蛋白及甲状腺转录因子在肺泡及呼吸性支气管中的分布及表达意义。结果：对照组中较之病膜组肺泡腔内出现较少的红染物质、且肺泡腔较大、具有明显的扩张，边缘仅有少许的腺样肺泡，上皮细胞整齐排列于支气管中；膜病组中，少量的肺泡表达且分散。呼吸性支气管上皮表达较为密集，而对照组较观察组分布相对均匀。膜病组中，上皮表达较少，腺样肺泡表达显著。且具有较多的肺泡边缘扩张，上皮着色显著于呼吸性支气管中。且为串珠状排列；比较两组的光密度值：膜病组患者表面活性蛋白B在肺泡细胞上皮表达的平均光密度值为0.26±0.16，显著低于对照组的0.36±0.16（t=2.297，P<0.05）；在呼吸性支气管上皮表达的平均光密度值为0.24±0.09，显著低于对照组的0.33±0.1（t=3.521，P<0.05）。甲状腺转录因子在肺泡细胞上皮表达的平均光密度值为0.35±0.12（t=3.521，P<0.05），低于对照组的0.39±0.2，组间差异具有统计学意义（t=3.309，P<0.05）；在呼吸性支气管上皮表达的平均光密度值为0.35±0.1，显著低于对照组的0.4±0.17（t=2.521，P<0.05）。结论：发表面活性蛋白B表达减少与新生儿肺透明膜病密切相关，且发表面活性蛋白B的减少与甲状腺转录因子的低表达有关。激活甲状腺转录因子与促进肺表面活性物质B可进一步通过临床的诊治疗效。

Objective:To analyze the expression of surfactant B and thyroid transcription factor in neonatal hyaline membrane disease.Methods:From July 2016 to May 2017, 57 neonates with hyaline membrane disease were divided into two groups:membrane disease group (n=35) and control group (n=22). Immunohistochemical staining was performed using SP method.The distribution and expression of active protein and thyroid transcription factor in alveolar and respiratory bronchi were detected.Results:In the control group, there were fewer red-stained substances in the alveolar cavity than in the diseased membrane group, and the alveolar cavity was larger, obviously dilated, only a small number of adenoid alveoli appeared at the edge, epithelial cells neatly arranged in the bronchi, While in the membrane disease group only a small amount of alveoli was expressed and dispersed.The expression of respiratory bronchial epithelium was more denser, while the distribution of control group was more uniform than that of the observation group.In membrane disease group, the expression of epithelium was low and the expression of adenoid alveoli was significant.There were more alveolar margin dilatation and epithelial staining in respiratory bronchi.The optical density of the two groups was compared:The mean optical density of surfactant B expression in alveolar epithelium of patients with membrane disease was 0.26±0.16, which was significantly lower than that of the control group 0.36±0.16(t=2.297,P<0.05);the average optical density of expression in respiratory bronchial epithelium was 0.24±0.09, which was significantly lower than that in the control group 0.33±0.1(t=3.521,P<0.05).The average optical density of thyroid transcription factor expression in alveolar epithelium was 0.35±0.12(t=3.521,P<0.05),the difference between the two groups was statistically significant(t=3.309,P<0.05);the mean optical density of the respiratory bronchial epithelium was 0.35±0.1, which was significantly lower than that of the control group 0.4±0.17(t=2.521,P<0.05).Conclusion:The decrease of the expression of surface active protein B is closely related to the neonatal lung disease, and the decrease of the surface active protein B is related to the low expression of thyroid transcription factor.Activation of thyroid transcription factor and promotion of pulmonary surfactant B can be helpful for clinical diagnosis and treatment.

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