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中华疝和腹壁外科杂志(电子版) ›› 2024, Vol. 18 ›› Issue (04) : 383 -389. doi: 10.3877/cma.j.issn.1674-392X.2024.04.005

论著

青海地区不同海拔男性腹股沟疝患者腹壁组织Ⅰ、Ⅲ型胶原纤维表达的研究
张洁宇1, 朱文君2, 高伟2, 王新昇2, 贺贝贝2, 吴世乐2,()   
  1. 1. 810000 西宁,青海大学临床医学院
    2. 810000 西宁,青海省人民医院普外科
  • 收稿日期:2024-03-28 出版日期:2024-08-18
  • 通信作者: 吴世乐
  • 基金资助:
    青海省人民医院院内课题项目(2023-qhsrmyy-34)

Study on the expression of type I and III collagen fibers in abdominal wall tissues of male inguinal hernia patients at different altitudes in Qinghai region

Jieyu Zhang1, Wenjun Zhu2, Wei Gao2, Xinsheng Wang2, Beibei He2, Shile Wu2,()   

  1. 1. College of Clinical Medicine, Qinghai University, Xining 810000, Qinghai Province, China
    2. General Surgery Department, Qinghai Provincial People's Hospital, Xining 810000, Qinghai Province, China
  • Received:2024-03-28 Published:2024-08-18
  • Corresponding author: Shile Wu
引用本文:

张洁宇, 朱文君, 高伟, 王新昇, 贺贝贝, 吴世乐. 青海地区不同海拔男性腹股沟疝患者腹壁组织Ⅰ、Ⅲ型胶原纤维表达的研究[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(04): 383-389.

Jieyu Zhang, Wenjun Zhu, Wei Gao, Xinsheng Wang, Beibei He, Shile Wu. Study on the expression of type I and III collagen fibers in abdominal wall tissues of male inguinal hernia patients at different altitudes in Qinghai region[J/OL]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2024, 18(04): 383-389.

目的

研究在不同海拔腹股沟疝患者的腹横筋膜Ⅰ型和Ⅲ型胶原纤维表达的含量,探究其胶原含量及比例是否存在差异。

方法

选取2022年9月至2023年5月在青海省人民医院普外科接受腹股沟疝手术的159例男性患者作为研究对象,分为海拔<2500 m组64例、2500~3500 m组48例及>3500 m组47例。检测标本取自腹横筋膜,面积约为10 mm×5 mm,免疫组织化学法检测Ⅰ、Ⅲ型胶原蛋白表达评分。

结果

Ⅰ型胶原纤维蛋白在<2500 m组的直疝中表达评分为21.0(10.5,24.0),斜疝表达评分为22.0(16.5,27.0),>3500 m组的直疝表达评分为10.0(6.0,15.5),斜疝表达评分为15.0(10.0,18.0),<2500 m组Ⅰ型胶原纤维蛋白表达含量高于>3500 m组。Ⅲ型胶原纤维蛋白在>3500 m组的直疝表达为16.0(14.0,20.8),斜疝表达评分为13.0(12.0,15.0),<2500 m组的直疝表达评分为10.0(10.0,16.0),斜疝表达评分为8.0(7.0,14.0),<2500 m组Ⅲ型胶原纤维蛋白表达含量低于>3500 m组;Ⅰ/Ⅲ值在<2500 m组的直疝为1.240(0.723,1.794),斜疝为1.969(1.286,3.375),>3500 m组的直疝为0.454(0.375,1.019),斜疝为0.833(0.692,1.308);各组中斜疝患者Ⅰ型/Ⅲ型的值高于直疝患者,差异均有统计学意义(P<0.05)。

结论

直疝和斜疝患者随着海拔变化,胶原含量存在差异,相较于<2500 m,海拔>3500 m对胶原纤维含量的负面影响更为显著;直疝患者胶原含量及比例与斜疝患者有差异,海拔变化对直疝患者群体的胶原代谢的影响更为突出。

Objective

To investigate the expression levels of type Ⅰ and Ⅲ collagen fibers in the transversalis fascia of inguinal hernia patients at different altitudes and to explore whether there are differences in collagen content and ratio.

Methods

In this study, 159 male patients who received inguinal hernia surgery in the Department of General Surgery of Qinghai Provincial People's Hospital from September 2022 to May 2023 were selected as the study objects, and were divided into 64 cases in the <2500 m group, 48 cases in the 2500~3500 m group, and 47 cases in the >3500 m group. The samples were collected from the transversalis fascia, the area was about 10 mm×5 mm, and the expression scores of collagen Ⅰ and Ⅲ were detected by the immunohistochemical (SP) method.

Results

The expression score of type I collagen fibers in the direct hernia of the <2500 m group was 21.0 (10.5, 24.0), and 22.0 (16.5, 27.0) in the indirect hernia; in the >3500 m group, the score was 10.0 (6.0, 15.5) for direct hernia and 15.0 (10.0, 18.0) for indirect hernia. The expression level of type Ⅰ collagen fibers in the <2500 m group was higher than in the >3500 m group. For type Ⅲ collagen fibers, the expression score in the >3500 m group was 16.0 (14.0, 20.8) for direct hernia and 13.0 (12.0, 15.0) for indirect hernia, while in the <2500 m group, the score was 10.0 (10.0, 16.0) for direct hernia and 8.0 (7.0, 14.0) for indirect hernia. The expression level of type Ⅲ collagen fibers in the <2500 m group was lower than in the >3500m group. The Ⅰ/Ⅲ ratio was 1.240 (0.723, 1.794) for direct hernia and 1.969 (1.286, 3.375) for indirect hernia in the <2500 m group, and 0.454 (0.375, 1.019) for direct hernia and 0.833 (0.692, 1.308) for indirect hernia in the >3500 m group. The Ⅰ/Ⅲ ratio in indirect hernia patients was higher than that in direct hernia patients. These differences were statistically significant (P<0.05).

Conclusion

The collagen content varies with altitude in direct and indirect hernia patients. Compared to <2500 m, the negative impact on collagen fiber content was more significant at an altitude of >3500 m. There were differences in collagen content and ratio between direct and indirect hernia patients, with altitude changes having a more pronounced effect on collagen metabolism in direct hernia patients.

表1 不同海拔各组腹股沟疝患者一般资料比较
图1 不同海拔各组腹股沟疝患者Ⅰ型胶原纤维蛋白着色表现(免疫组织化学法)注:1A <2500 m组Ⅰ型胶原纤维蛋白(200×);1B 2500~3500 m组Ⅰ型胶原纤维蛋白(200×);1C >3500 m组Ⅰ型胶原纤维蛋白(200×)。
图2 不同海拔各组腹股沟疝患者Ⅲ型胶原蛋白着色表现(免疫组织化学法)注:2A <2500 m组Ⅲ型胶原纤维蛋白(200×);2B 2500~3500 m组Ⅲ型胶原纤维蛋白(200×);2C >3500 m组Ⅲ型胶原纤维蛋白(200×)。
图3 不同海拔下直疝胶原纤维蛋白表达评分
图4 不同海拔下斜疝胶原纤维蛋白表达评分
表2 不同海拔各组直疝患者Ⅰ型、Ⅲ型胶原纤维蛋白表达评分差异分析
表3 不同海拔各组斜疝患者Ⅰ型、Ⅲ型胶原纤维蛋白表达评分差异分析
图5 海拔<2500 m组直疝、斜疝患者Ⅰ、Ⅲ型胶原纤维蛋白表达评分比较
图6 海拔2500~3500 m组直疝、斜疝患者Ⅰ、Ⅲ型胶原纤维蛋白表达评分比较
图7 海拔>3500 m组直疝、斜疝患者Ⅰ、Ⅲ型胶原纤维蛋白表达评分比较
表4 不同海拔各组直疝、斜疝患者间Ⅰ型、Ⅲ型胶原纤维蛋白表达评分比较
[1]
Schroeder AD, Tubre DJ, Fitzgibbons RJ Jr. Watchful Waiting for Inguinal Hernia[J]. Adv Surg, 2019, 53: 293-303.
[2]
Podolsky D, Novitsky Y. Robotic Inguinal Hernia Repair[J]. Surg Clin North Am, 2020, 100(2): 409-415.
[3]
HerniaSurge G. International guidelines for groin hernia management [J]. Hernia, 2018, 22(1): 1-165.
[4]
Sanford Z, Weltz AS, Brown J, et al. Morgagni Hernia Repair: A Review[J]. Surg Innov, 2018, 25(4): 389-399.
[5]
Henriksen NA, Mortensen JH, Sorensen LT, et al. The collagen turnover profile is altered in patients with inguinal and incisional hernia[J]. Surgery, 2015, 157(2): 312-321.
[6]
Li J, Zhang X, Sun Q, et al. Circulating matrix metalloproteinases and procollagen propeptides in inguinal hernia[J]. Hernia, 2018, 22(3): 541-547.
[7]
Jorgenson E, Makki N, Shen L, et al. A genome-wide association study identifies four novel susceptibility loci underlying inguinal hernia[J]. Nat Commun, 2015, 6: 10130.
[8]
中华医学会外科学分会疝与腹壁外科学组, 中国医师协会外科医师分会疝和腹壁外科医师委员会. 成人腹股沟疝诊断和治疗指南(2018年版)[J/OL]. 中华疝和腹壁外科杂志(电子版), 2018, 12(4): 244-246.
[9]
杨柳. 成人腹股沟疝患者腹横筋膜中Ⅰ、Ⅲ型胶原的表达及分析[D]. 西宁: 青海大学, 2018.
[10]
凌佳怡, 谢芳, 杜婷, 等. 免疫检查点分子PD-L1和B7-H4在卵巢癌组织中的表达及意义[J]. 现代免疫学, 2023, 43(1): 36-41.
[11]
卢奎, 周孝峰, 韩涛, 等. 食管鳞癌组织RNF168和STAT1蛋白表达及预后观察[J]. 中华肿瘤防治杂志, 2021, 28(23): 1798-1804.
[12]
中国医师协会外科医师分会疝和腹壁外科专业(青年), 大中华腔镜疝外科学院. 成人腹股沟疝患者教育中国专家共识[J/OL]. 中华疝和腹壁外科杂志(电子版), 2022, 16(6): 619 -623.
[13]
Bouzada J, Gemmell C, Konschake M, et al. New Insights Into the Development of the Anterior Abdominal Wall[J]. Front Surg, 2022, 9: 863679.
[14]
Jadav D, Gorchiya A, Shekhawat RS, et al. Traumatic inguinal hernia: Exploring the possible mechanism of its causation[J]. Med Sci Law, 2022, 62(1): 74.
[15]
Stephenson BM. Epidemiology and Etiology of Primary Groin Hernias[M]//Leblanc KA, Kingsnorth A, Sanders DL. Management of Abdominal Hernias. Cham: Springer International Publishing, 2018: 59-77.
[16]
Öberg S, Andresen K, Rosenberg J. Etiology of Inguinal Hernias: A Comprehensive Review[J]. Front Surg, 2017, 4: 52.
[17]
Bracale U, Peltrini R, Iacone B, et al. A Systematic Review on the Role of Matrix Metalloproteinases in the Pathogenesis of Inguinal Hernias[J]. Biomolecules, 2023, 13(7): 1123.
[18]
Wang D, Han Y, Xu X, et al. Matrix Metalloproteinases(MMP-2) and Tissue Inhibitors of Metalloproteinases(TIMP-2) in Patients with Inguinal Hernias[J]. World J Surg, 2020, 44(11): 3679-3686.
[19]
Ruhl CE, Everhart JE. Risk factors for inguinal hernia among adults in the US population[J]. Am J Epidemiol, 2007, 165(10): 1154-1161.
[20]
Ren J, Yang M, Xu F, et al. Acceleration of wound healing activity with syringic acid in streptozotocin induced diabetic rats[J]. Life Sci, 2019, 233: 116728.
[21]
Lang M, Bilo G, Caravita S, et al.[Blood pressure and high altitude: physiological response and clinical management][J]. Medwave, 2021, 21(4): e8194.
[22]
Getu A. Ethiopian Native Highlander's Adaptation to Chronic High-Altitude Hypoxia[J]. Biomed Res Int, 2022, 2022: 5749382.
[23]
官丽敏 王旭萍. 缺氧时肺动脉平滑肌细胞血红素氧合酶/一氧化碳系统的变化及其对Ⅰ型胶原的影响[J]. 高原医学杂志, 2004, 14(1): 37.
[24]
党相琛. 不同海拔高度对军人有氧能力影响因素研究[D]. 天津: 天津体育学院, 2022.
[25]
张升敏, 黄健斌, 陈亮, 等. Ⅰ、Ⅲ型胶原蛋白在成人腹股沟斜疝及直疝患者腹横筋膜和疝囊的表达[J/OL]. 中华疝和腹壁外科杂志(电子版), 2023, 17(5): 516 -521.
[26]
王静, 周美仙. 基质金属蛋白酶-2及金属蛋白酶组织抑制因子-2在成人腹股沟疝患者腹直肌前鞘中的表达水平及与年龄相关性分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2021, 15(1): 57-60.
[27]
Szczesny W, Szczepanek J, Tretyn A, et al. An analysis of the expression of collagen I and Ⅲ genes in the fascia of obese patients[J]. J Surg Res, 2015, 195(2): 475-480.
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