CAJ | 학술논문

目的:测定一氧化氮(NO)在先天性肥厚性幽门狭窄(CHPS)肥厚肌中的改变,血中含量及术前术后的改变,探讨CHPS的发生和病理生理改变.方法:用还原性辅酶Ⅰ(NADPHd)组织化学染色法测定组织中一氧化氮合酶(NOS)含量;用比色法测定血中NO含量.21例CHPS术中取幽门肥厚之肌层;5例非幽门疾病取幽门肌层.结果:CHPS组肥厚之环状肌层无NADPHd(+)神经纤维染色,偶见扭曲、变形、染色浅的神经纤维.非幽门疾病组幽门环状肌、纵状肌、肌间神经元显示强NADPHd(+)染色.血中NO含量CHPS组和非幽门疾病组之间差异无显著性(P=0.6);CHPS组术前术后之间差异无显著性(P=0.5).结论:CHPS患儿肥厚之环状肌中NOS缺如或明显减少,致幽门失松弛,幽门梗阻.血中NO含量因受多种因素影响,病理生理意义不完全明了,推测CHPS可能是定位于幽门的局限性疾病.
목적:측정일양화담(NO)재선천성비후성유문협착(CHPS)비후기중적개변,혈중함량급술전술후적개변,탐토CHPS적발생화병리생리개변.방법:용환원성보매Ⅰ(NADPHd)조직화학염색법측정조직중일양화담합매(NOS)함량;용비색법측정혈중NO함량.21례CHPS술중취유문비후지기층;5례비유문질병취유문기층.결과:CHPS조비후지배상기층무NADPHd(+)신경섬유염색,우견뉴곡、변형、염색천적신경섬유.비유문질병조유문배상기、종상기、기간신경원현시강NADPHd(+)염색.혈중NO함량CHPS조화비유문질병조지간차이무현저성(P=0.6);CHPS조술전술후지간차이무현저성(P=0.5).결론:CHPS환인비후지배상기중NOS결여혹명현감소,치유문실송이,유문경조.혈중NO함량인수다충인소영향,병리생리의의불완전명료,추측CHPS가능시정위우유문적국한성질병.
Objective:To search the changes of nitric oxide (NO) in hypertrophic pyloric muscles and blood of infants with congenital hypertrophic pyloric stenosis (CHPS).Methods:The distribution of NO synthase(NOS)in the pyloric muscles was studied by nicotinamide adenine dinucleotide phosphate diaphorase(NADPHd) histochemical reaction.Twenty-one muscular specimens obtained from pyloromyotomy.and 5 specimens from infants without pyloric diease served as control group.NO level in the blood of 9 cases with CHPS and the control (26 blood samples) was measured by chromometry.Results:NADPHd activity was absent in the fibers of the hypertrophied pyloric circular muscles,and only a few nerve fibers in the longitudinal muscles and myenteric plexus.Intense NADPHd was present in the nerve fibers of circular and longitudinal muscles,the neurons and myenteric plexus of control group.There was no difference of NO levels in the blood between the two groups (P = 0.6),and no significant difference in the blood of CHPS group before and after operation(P=0.5).Conclusions;Lack of NOS in pyloric muscles may be responsible to the achalasia of pyloric sphincter and lead to pyloric obstruction while changes of NO levels in blood has no clinical significance.We infer that the pathological changes may be localized in the circular pyloric muscles.