中华小儿外科杂志
中華小兒外科雜誌
중화소인외과잡지
CHINESE JOURNAL OF PEDIATRIC SURGERY
2008年
5期
281-283
,共3页
席红卫%吴晓霞%崔彦北%王建峰
席紅衛%吳曉霞%崔彥北%王建峰
석홍위%오효하%최언북%왕건봉
梅克尔憩室%平滑肌细胞%肠神经系统
梅剋爾憩室%平滑肌細胞%腸神經繫統
매극이게실%평활기세포%장신경계통
Meckel's dirverticulum%Smooth muscle cells%Enteric nervous system
目的 了解梅克尔憩室(MD)肠壁神经和平滑肌病理组织学改变,探讨MD及其并发症的发病机制.方法 收集2004年1月至2006年7月手术切除的44例MD标本,另取6例死于与肠道和神经系统无关疾病的足月新生儿尸检小肠标本为对照,采用常规HE染色计数肠壁肌间神经丛和丛内神经节细胞数,S-100蛋白、神经元特异性烯醇化酶(NSE)和平滑肌肌动蛋白(α-SMA)采用免疫组织化学染色(SABC法).结果 MD的肠壁肌间神经丛密度与对照组相比无统计学意义(P＞0.05),但丛内神经节细胞数、单个肌间神经丛的平均面积及其平均神经丛长轴长度均较对照组减少,而平均光密度值比对照组增加.肌间神经丛的平均面积与其平均吸光度呈负相关(r=一0.215,P＜0.05),且上述病理改变以症状组和伴有异位胃黏膜的MD尤为突出.MD的肠壁环肌层和纵肌层α-SMA表达减低,环肌层肥厚;而距憩室5 cm处肠壁肌间神经丛的各项指标的改变均减轻,但是环肌层仍明显肥厚,α-SMA染色亦减轻.结论 肠壁神经丛和平滑肌细胞的变化可能参与了MD及其并发症的发生.
目的 瞭解梅剋爾憩室(MD)腸壁神經和平滑肌病理組織學改變,探討MD及其併髮癥的髮病機製.方法 收集2004年1月至2006年7月手術切除的44例MD標本,另取6例死于與腸道和神經繫統無關疾病的足月新生兒尸檢小腸標本為對照,採用常規HE染色計數腸壁肌間神經叢和叢內神經節細胞數,S-100蛋白、神經元特異性烯醇化酶(NSE)和平滑肌肌動蛋白(α-SMA)採用免疫組織化學染色(SABC法).結果 MD的腸壁肌間神經叢密度與對照組相比無統計學意義(P＞0.05),但叢內神經節細胞數、單箇肌間神經叢的平均麵積及其平均神經叢長軸長度均較對照組減少,而平均光密度值比對照組增加.肌間神經叢的平均麵積與其平均吸光度呈負相關(r=一0.215,P＜0.05),且上述病理改變以癥狀組和伴有異位胃黏膜的MD尤為突齣.MD的腸壁環肌層和縱肌層α-SMA錶達減低,環肌層肥厚;而距憩室5 cm處腸壁肌間神經叢的各項指標的改變均減輕,但是環肌層仍明顯肥厚,α-SMA染色亦減輕.結論 腸壁神經叢和平滑肌細胞的變化可能參與瞭MD及其併髮癥的髮生.
목적 료해매극이게실(MD)장벽신경화평활기병리조직학개변,탐토MD급기병발증적발병궤제.방법 수집2004년1월지2006년7월수술절제적44례MD표본,령취6례사우여장도화신경계통무관질병적족월신생인시검소장표본위대조,채용상규HE염색계수장벽기간신경총화총내신경절세포수,S-100단백、신경원특이성희순화매(NSE)화평활기기동단백(α-SMA)채용면역조직화학염색(SABC법).결과 MD적장벽기간신경총밀도여대조조상비무통계학의의(P＞0.05),단총내신경절세포수、단개기간신경총적평균면적급기평균신경총장축장도균교대조조감소,이평균광밀도치비대조조증가.기간신경총적평균면적여기평균흡광도정부상관(r=일0.215,P＜0.05),차상술병리개변이증상조화반유이위위점막적MD우위돌출.MD적장벽배기층화종기층α-SMA표체감저,배기층비후;이거게실5 cm처장벽기간신경총적각항지표적개변균감경,단시배기층잉명현비후,α-SMA염색역감경.결론 장벽신경총화평활기세포적변화가능삼여료MD급기병발증적발생.
Objective To investigate the pathologic changes of enteric nerves and smooth muscle cells of Meckel's diverticulum,and its relationship to the complications.Methods Full thickness samples were obtained from 44 patients during operation on Meckel's diverticulitis between January 2004 and July 2006.The intestines from newborns that died from causes unrelated to gastrointestinal or nervous system diseases were selected as controls.All specimens were stained with haematoxylin and eosin(HE)and SABC immunohistochemistry.Results There was no significant difference in the density of mesenteric nerve plexus between the two groups(P＞0.05).The reduction of ganglionic cells and average long axis of mesenteric nerve plexus with an increasing of mean optical density were observed on Meckel's diverticulitis.There were negative correlation of the average area of mesenteric plexus with the mean optical absorbance(r=-0.215,P＜0.05),which was obvious in specimens of diverticulitis with ectopic gastric mucosa.A remarkable decrease in staining intensity of α-SMA was mainly observed on the hypertrophic circular muscular layer of Meckel's diverticulitis.The alteration patterns of mesenteric ganglionic plexus were markedly reduced at intestine more than 5 cm apart from the(diverticulum,but the circular muscle was still hypertrophy with a decrease inα-SMA expression.Conclusions The authors consider that the alternations of enteric nerves and smooth muscles might contribute to the pathogenesis of Meckel's diverticulitis.
