CAJ | 학술논문

目的：研究突触素（ SY ）在慢传输型便秘（ STC ）患者肠神经系统中的表达情况。方法选择肠道造影提示有结肠痉挛并经手术证实 STC 者20例，取其乙状结肠（痉挛段）及横结肠（近端非痉挛段）肠壁标本为实验组；无结肠痉挛的 STC 患者20例，取其乙状结肠及横结肠肠壁标本为对照组。2组标本均进行免疫组化检测，分析突触素在 STC 患者结肠壁的表达情况。结果突触素在2组便秘患者结肠壁肌层的表达均比黏膜下层表达增高（P＜0.05），实验组的横结肠黏膜下层突触素的表达明显低于对照组（P ＜0.05），其余组间突触素的表达差异无统计学意义。结论 STC患者横结肠与乙状结肠结肠壁肌层突触素的表达均明显高于黏膜下层的表达，与其生理功能相一致。乙状结肠痉挛的发生与突触素的表达水平无相关。突触素在结肠痉挛区近端横结肠黏膜下层的表达减少，可能与其远端乙状结肠肠管持续痉挛导致其近端横结肠发生进行性退变引起代偿性、继发性肠管扩大肥厚造成的肠管扩张和蠕动减弱相关。
목적：연구돌촉소（ SY ）재만전수형편비（ STC ）환자장신경계통중적표체정황。방법선택장도조영제시유결장경련병경수술증실 STC 자20례，취기을상결장（경련단）급횡결장（근단비경련단）장벽표본위실험조；무결장경련적 STC 환자20례，취기을상결장급횡결장장벽표본위대조조。2조표본균진행면역조화검측，분석돌촉소재 STC 환자결장벽적표체정황。결과돌촉소재2조편비환자결장벽기층적표체균비점막하층표체증고（P＜0.05），실험조적횡결장점막하층돌촉소적표체명현저우대조조（P ＜0.05），기여조간돌촉소적표체차이무통계학의의。결론 STC환자횡결장여을상결장결장벽기층돌촉소적표체균명현고우점막하층적표체，여기생리공능상일치。을상결장경련적발생여돌촉소적표체수평무상관。돌촉소재결장경련구근단횡결장점막하층적표체감소，가능여기원단을상결장장관지속경련도치기근단횡결장발생진행성퇴변인기대상성、계발성장관확대비후조성적장관확장화연동감약상관。
Objective It is tO explOre the expressiOn Of synaptOphysin( SY)in the enteric nervOus system in slOw transit cOnstipatiOn( STC)patients. Methods 20 cases with cOlOn spasms prOmpted by intestinal tract imaging and cOnfirmed by sur-gery were selected in which a specimen each Of the sigmOid cOlOn wall( the part Of spasm )and transverse cOlOn wall( the prOximal part Of nO spasm)was made as the experimental grOup;20 STC patients with nO cOlOn spasm were selected and the same specimen frOm the same part Of cOlOnic wall was made as the cOntrOl grOup. The expressiOn Of SY in cOlOnic wall was de-tected by immunOhistOchemical methOd in the specimen Of bOth grOups. Results The expressiOn Of SY in cOlOn wall muscle lay-er was higher than that Of SY in submucOsa layer in the patients with STC in bOth grOups(P <0. 05),and the expressiOn Of SY in transverse cOlOn submucOsa Of the experimental grOup was significantly lOwer than that Of the cOntrOl grOup(P< 0. 05). The rest Of the expressiOn difference Of SY in the twO grOups was nOt significant. Conclusion The expressiOn Of SY in the trans-verse cOlOn wall muscle layer and sigmOid cOlOn wall muscle layer Of patients with STC is significantly higher than that in sub-mucOsa,and cOnsistent with its physiOlOgical functiOn. The happening Of spasm in the sigmOid cOlOn is nOthing tO dO with the expressiOn level Of SY. The expressiOn Of SY Of the transverse cOlOn submucOsa( the prOximal part Of spasm)is reduced, which may be related tO intestinal canal expanded and peristalsis abate by cOmpensatOry Or secOndary intestinal canal expanded hypertrOphy ,which is caused by prOgressive degeneratiOn in prOximal transverse cOlOn caused by cOntinuOus spasm in distal sigmOid cOlOn.