目的探讨受激活调节正常T细胞表达和分泌因子(RANTES)在下肢静脉性溃疡的发病中的作用。方法采用半定量逆转录-聚合酶链反应(RT-PCR)方法检测下肢静脉溃疡患者(溃疡组,20例)、单纯下肢静脉功能不全患者(无溃疡组,20例)和健康人(对照组,10例)下肢外周血RANTESmRNA的表达;采用免疫组织化学方法检测下肢静脉溃疡病人溃疡周围正常皮肤组织、手术前溃疡组织和手术后愈合溃疡和愈合中溃疡组织RANTES的表达。结果溃疡组血液RANTESmRNA的表达与无溃疡组和对照组相比差异有统计学意义(P〈0.05);无溃疡组和对照组相比差异有统计学意义(P〈0.05);每高倍镜下溃疡周围正常皮肤组织RANTES的阳性表达数为28±13,手术前溃疡组织RANTES的阳性表达数为107±44,手术后愈合溃疡和愈合中溃疡组织RANTES的阳性表达数为35±20;与溃疡周围正常皮肤组织相比,手术前溃疡组织RANTES的表达显著增高(P〈0.05);手术后愈合溃疡和愈合中溃疡组织RANTES的表达较手术前溃疡组织明显降低。结论RANTES的高表达可能是下肢静脉性溃疡发病机制之一。
Objective To study the effectiveness of RANTES in the pathogenesy of venous ulceration. Methods 40 Chronic venous insufficiency (CVI) individuals were enrolled in the study and separated into the ulceration group (n = 20 ) and non-ulceration group (n = 20), according to CVI with or without ulceration, 10 healthy individuals were enrolled as control group. The expression of RANTES mRNA was analyzed by reverse transcription-polymerase chain reaction (RT-PCR) in blood. Immunohistochemical staining of RANTES were carried in normal skin, in the tissue at the brim of ulceration and in the tissue of cured or curing ulceration. Results In ulceration group, the dxpression of RANTES mRNA in blood increased obviously. Compared with the other two groups, they were significant different ( P 〈 0. 05 ). The difference was also significance in the other two groups( P 〈 0. 05 ). The average number of RANTES positive expression in normal skin is 28 ± 13, in the tissue at the brim of ulceration is 107 ± 44, and in the tissue of cured or curing ulceration is 35 ± 20. There are significant difference between normal skin and the tissue at the brim of ulceration( P 〈 0. 05 ). The average number of RANTES positive expression in the tissue of cured or curing ulceration is lower than that' s in the tissue at the brim of ulceration. Conclusion The high expression of RANTES may be one of the important mechanisms of varicose ulcer.