寻常疣患者应用贴麻后火针剥除术对凋亡抑制基因Livin及细胞增殖相关基因表达的影响  

Effects of Fire-needle Stripping after Local Anaesthesia on the Expression of Apoptosissuppressing Gene Livin and Cell Proliferation-related Genes in Patients with Common Warts

作　　者：王莹 徐俊涛 王丽 王刚[2] 李天举[3] 赵巍 方玉甫 WANG Ying;XU Juntao;WANG Li;WANG Gang;LI Tianju;ZHAO Wei;FANG Yufu(Department of Dermatology,Henan Province Hospital of Traditional Chinese Medicine,the Second Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450003,China;Department of Dermatology,the First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450000,China;Department of Dermatology,Zhengzhou People's Hospital,Zhengzhou 450000,China)

机构地区：[1]河南省中医院(河南中医药大学第二附属医院)皮肤科,河南郑州450003 [2]河南中医药大学第一附属医院皮肤科,河南郑州450000 [3]郑州人民医院皮肤科,河南郑州450000

出　　处：《中国皮肤性病学杂志》2021年第9期975-982,共8页The Chinese Journal of Dermatovenereology

基　　金：国家中医临床研究基地科研专项课题(2019JDZX044)。

摘　　要：目的探究寻常疣患者应用贴麻后火针剥除术对凋亡抑制基因Livin及细胞增殖相关基因表达的影响。方法便利抽样法选取符合要求的450例寻常疣患者,按随机数余数法分为A(贴麻后火针剥除术)、B(火针治疗)、C(液氮冷冻治疗)三组,每组150例,比较三组疗效;采用视觉模拟评分(VAS)评估三组治疗期间、治疗1 h、治疗3 h自觉疼痛程度的差别;治疗前后均留取寻常疣皮损组织,匀浆后测定凋亡抑制基因Livin、Survivin、XIAP及细胞增殖相关基因Cyclin D1、p16INK4、CDK6、E2F的变化;采用原位缺口末端标记(TUNEL)法检测细胞凋亡数目;并检测治疗前后巨噬细胞细胞炎症蛋白3α(MIP-3α)、肿瘤坏死因子-α(TNF-α)、白介素-1α(IL-1α)等促炎因子的变化;观察治疗不良反应发生情况。结果有效率对比:A组(96.67%)>B组(90.00%)>C组(79.33%),差异有统计学意义(P<0.05);A组疣体完全清除时间[(8.61±1.23)周]短于B、C组[(9.78±0.52)周、(10.63±0.41)周],B组又短于C组(P<0.05);A、C组治疗不同时间VAS评分相近,均低于B组(P<0.05);治疗8周,三组Livin、Survivin、XIAP、Cyclin D1、p16INK4、CDK6、E2F、MIP-3α、TNF-α、IL-1α均较同组治疗前降低(P<0.05),A组Livin、Survivin、XIAP、Cyclin D1、p16INK4、CDK6、E2F、MIP-3α、TNF-α、IL-1α基因相对表达量低于B、C组(P<0.05),B组又低于C组(P<0.05);A组细胞凋亡数目[(66.71±10.26)%、]高于B、C组[(56.52±6.79)%、(50.01±5.79)%],B组又高于C组(P<0.05);A组不良反应发生率(4.67%)低于B组(12.67%)(P<0.05)。结论贴麻后火针剥除术可通过抑制寻常疣患者皮损组织凋亡抑制基因及细胞增殖基因表达,促进细胞凋亡,抑制角质形成细胞增殖,控制疣体增生及局部炎症反应,优化疗效,减轻患者疼痛感,安全可行。Objective To explore the effects of fire-needle stripping after local anaesthesia on the expression of apoptosis-suppressing gene Livin and cell proliferation-related genes in patients with common warts.Methods A total of 450 eligible patients with common warts were selected by convenient sampling method and then divided into group A(fire-needle stripping after local anesthesia),group B(fire-needle treatment)and group C(liquid nitrogen cryotherapy)by random number remainder method,with 150 cases in each group.The curative effect was compared among the three groups.The differences in conscious pain degree during treatment,one hour treatment and three hours treatment in the three groups were evaluated by visual analog scale(VAS).Before and after treatment,skin lesions tissues of common warts were collected.After homogenate,changes in apoptosis inhibitory genes(Livin,Survivin,XIAP)and cell proliferation related genes(Cyclin D1,p16INK4,CDK6,E2F)were determined.The number of cells apoptosis was detected by TdT-mediated dUTP nick-end labeling(TUNEL).The changes in pro-inflammatory factors such as macrophage inflammatory protein 3-α(MIP-3α),tumor necrosis factor-α(TNF-α)and interleukin-1α(IL-1α)before and after treatment were detected.The adverse effects of treatment were observed.Results The response rate was the highest in group A(96.67%),followed by group B(90.00%),and group C(79.33%)(P<0.05).The complete warts removal time was the shortest in group A[(8.61±1.23)weeks],followed by group B[(9.78±0.52)weeks]and group C[(10.63±0.41)weeks](P<0.05).VAS scores in group A and group C were similar,which were lower than those in group B(P<0.05).At eight weeks after treatment,Livin,Survivin,XIAP,Cyclin D1,p16INK4,CDK6,E2F,MIP-3α,TNF-αand IL-1αin the three groups were lower than those before treatment(P<0.05).The relative expression levels of Livin,Survivin,XIAP,Cyclin D1,p16INK4,CDK6,E2F,MIP-3α,TNF-αand IL-1αgenes were the lowest in group A,followed by group B and group C(P<0.05).The number of cells apoptosis wa

关 键 词：寻常疣 贴麻 火针剥除术 液氮冷冻 凋亡抑制基因 细胞增殖 

分 类 号：R752.51[医药卫生—皮肤病学与性病学]