糖尿病患者牙髓组织病变及IL-8、VEGF表达的研究

目的研究糖尿病患者(diabetes mellitus,DM)和正常人牙髓血管形态结构及IL-8含量、VEGF表达的差异。方法DM组30例为Ⅱ型DM患者因阻生拔除的外观完好无牙髓病症状的第三磨牙,对照组30例为正常人因阻生拔除的健康牙齿。采用酶联免疫吸附试验(ELISA)分别检测2组牙髓组织中IL-8的含量。光镜下观察2组牙髓组织的结构特点,并对牙髓标本进行血管内皮生长因子(VEGF)的免疫组化染色,通过Image pro-plus 6.0图像分析软件对牙髓组织中VEGF染色进行定量分析。应用SAS6.12软件包对试验数据进行统计分析。结果 DM组牙髓中IL-8含量高于正常牙髓(P=0.0455<0.05)。光镜下DM组牙髓中可见毛细血管壁增厚。VEGF在对照组和DM组牙髓中都有表达,DM组牙髓中的表达增强(P<0.01,成牙本质细胞P<0.001,成纤维细胞P<0.01,血管内皮细胞P<0.01)。结论 DM患者即使是无龋坏、无创伤缺损、无症状的牙齿牙髓也出现了炎症反应。VEGF在DM患者牙髓中的高表达提示其牙髓发生了损伤与修复过程,发生在DM患者外周微血管的病变同样也发生在了牙髓中,提示DM与其牙髓病变具有相关性。

Study of expression of IL-8 and VFGF and pathological changes in pulp tissues of diabetes mellitus patients

Objective To investigate difference in expression of IL-8 and VEGF and morphology of dental pulp vascular of patients with diabetes mellitus and healthy people.Methods Pulp tissues were obtained from clinically extracted healthy teeth because of impaction(control group,30cases) and clinically extracted non-insulin dependent diabetes patients' intact third molars because of impaction whilst without pulposis syndromes(diabetic group,30cases).IL-8 levels in the two groups were measured with ELISA method.Dental pulp structures in two groups were observed under the light microscope.Immunohistochemistrical staining was performed to detect VEGF in the dental pulp samples.VEGF staining in dental pulp tissues were quantitatively determined with Image-pro Pulps 6.0 Analysis System.All data in the experiment were statistically analyzed with SAS6.12 statistical software.Resluts The level of IL-8 in diabetic pulp group was higher than that in normal pulp group(P=0.0455<0.05).Thicker blood capillary wall was observed in diabetic pulp under the light microscope.VEGF was detected in normal and diabetic pulp tissues and significantly higher levels of VEGF were found in diabetic pulps(P=0.0000<0.01).The expression of VEGF was positive in the odontoblasts,pulp fibroblasts and vascular endothelial cells.Compared with the normal group,the VEGF expression of these three kinds of cells in patients with diabetes mellitus was significantly up-regulated(odontoblasts P=0.0000<0.01;pulp fibroblasts P=0.0000<0.001;vascular endothelial cells P=0.0000 < 0.01).Conclusions The inflammatory reaction exists in pulp tissues of intact diabetic teeth,although the teeth have not dental caries and syndromes.The high expression of VEGF in dental pulps of dialectical patients indicates the injury and recovery process.The changes observed in the diabetic periphery vasculars may occur in the dental pulps,indicating that diabetes mellitus is closely related to the pulposis.