论文部分内容阅读
目的：为了探索Graves眼病的确切发病机制。方法；应用布克隆抗体人类白细胞DR抗原（HLA－DR）、巨噬细胞（CD68）、第八因子相关性抗原（F8／86）、T细胞（CD3）、辅助性／诱导性T细胞（CD4）、抑制性／细胞毒T细胞（CD8）、B细胞（CD20）对11例Graves眼病患者球后组织主要为眼外肌标本冰冻或石蜡切片用碱性磷酸酶－抗碱性磷酸酶（APAAP）法进行免疫组织化学研究，5例正常人眼外肌作为对照。结果：（1）Graves眼病患者眼外肌肌纤维细胞内无DR表达，但在其间质中有大量的DR阳性细胞、这些DR阳性细胞包括巨噬细胞（CD68阳性）、淋巴细胞、部分血管内皮细胞（F8／86阳性）及成纤维细胞样细胞；（2）CD68染色显示Craves眼外肌中有大量的巨噬细胞浸润；（3）FS／86染色显示Graves眼外肌中血管丰富、扩张；（4）Graves眼外肌中淋巴细胞是弥漫性和／或局灶性浸润，以T细胞为主（CD3阳性），B细胞相对较少（CD20阳性），CD4阳性细胞较CD8阳性细胞略占优势。淋巴细胞多呈DR阳性染色。5例未见淋巴细胞浸润。（5）球后脂肪与上述抗体无阳性反应。结论：研究提示眼外肌是Graves眼病自身免疫反应进行的主要部位，其间质细胞中HLA－DR抗原的异常表达在该病的发生发展中起重要作用。细胞免疫在局部炎症中有重要意义。
Objective: To explore the exact pathogenesis of Graves ophthalmopathy. Methods The expression of HLA-DR, CD68, F8 / 86, T cell (CD3), CD4 (superscript +) T cell ), Inhibitory / cytotoxic T cells (CD8) and B cells (CD20) in 11 patients with Graves ophthalmopathy were mainly extraocular muscle samples frozen or paraffin sections with alkaline phosphatase - anti-alkaline phosphatase (APAAP ) Method for immunohistochemistry, 5 cases of normal extraocular muscles as a control. Results: (1) There was no DR expression in extraocular muscle fibers in patients with Graves ophthalmopathy, but there were a large number of DR positive cells in the interstitium. These DR positive cells include macrophages (CD68 positive), lymphocytes, partial vascular endothelium (F8 / 86 positive) and fibroblast-like cells; (2) CD68 staining showed a large number of macrophage infiltration in the extracranial muscle of Craves; (3) FS / 86 staining showed that the vessels in Graves’ ; (4) Graves extraocular muscle lymphocytes are diffuse and / or focal infiltration, mainly T cells (CD3 positive), B cells are relatively less (CD20 positive), CD4 positive cells than CD8 positive cells slightly Dominant. Lymphocytes were mostly DR positive staining. No infiltration of 5 cases of lymphocytes. (5) There is no positive reaction with the above antibody after the ball. Conclusion: Extraocular muscle is the main part of autoimmune reaction of Graves’ eye. The abnormal expression of HLA-DR antigen in interstitial cells plays an important role in the development of the disease. Cellular immunity is of great importance in local inflammation.