CAJ | 학술논문

目的：探讨便秘患者结肠痉挛与肠神经系统之间的联系，揭示慢传输型便秘（STC）患者伴发结肠痉挛症状的病理生理基础。方法选取外科手术治疗的 STC 患者。影像学检查和/或手术当中发现有肠管痉挛的 STC 患者为实验组，共19例；影像学检查及手术时均未发现肠道痉挛的患者为对照组，共20例。应用免疫组化方法对肠壁神经系统中的蛋白基因产物9.5（PGP9.5）及组织蛋白酶（CAD）进行检测，观察神经系统中神经元、神经丛的数量。结果 CAD 及 PGP9.5免疫组化染色定量分析结果相同。与对照组比较，实验组乙状结肠黏膜下层和乙状结肠肌层神经节细胞数均较少（ P 均﹤0.05）。实验组和对照组横结肠黏膜下层、肌层神经丛数、节细胞数以及乙状结肠黏膜下层、肌层神经丛数比较均无明显差异（P 均﹥0.05）。结论 STC 患者局部结肠痉挛与肠神经系统神经节细胞的数量进一步减少有关，与神经丛数量关系不明显。
목적：탐토편비환자결장경련여장신경계통지간적련계，게시만전수형편비（STC）환자반발결장경련증상적병리생리기출。방법선취외과수술치료적 STC 환자。영상학검사화/혹수술당중발현유장관경련적 STC 환자위실험조，공19례；영상학검사급수술시균미발현장도경련적환자위대조조，공20례。응용면역조화방법대장벽신경계통중적단백기인산물9.5（PGP9.5）급조직단백매（CAD）진행검측，관찰신경계통중신경원、신경총적수량。결과 CAD 급 PGP9.5면역조화염색정량분석결과상동。여대조조비교，실험조을상결장점막하층화을상결장기층신경절세포수균교소（ P 균﹤0.05）。실험조화대조조횡결장점막하층、기층신경총수、절세포수이급을상결장점막하층、기층신경총수비교균무명현차이（P 균﹥0.05）。결론 STC 환자국부결장경련여장신경계통신경절세포적수량진일보감소유관，여신경총수량관계불명현。
Objective It is to approach the correlation between colonospasm and enteric nervous system in patients with constipation,and reveal the pathophysiological basis of slow transit constipation(STC)with colonospasm. Methods The pa-tients who accepted the operation for STC were selected as the object of observation. 19 STC patients with colonospasm found by imaging of X - ray and(or)surgery were selected as experimental group. 20 STC patients without colonospasm were select-ed as control group. The expressions of PGP9. 5 and CAD in enteric nervous system were detected by immunohistochemistry method. Then the number of the nerve plexus and ganglion cells were observed. Results The results were not significant differ-ences between CAD and PGP9. 5. The number of ganglion cells in sigmoid submucosa and muscular layer in experimental group were less than that in control groups(all P ﹤ 0. 05). There were no significant differences in number of ganglion cells and nerve plexus of transverse colon and number nerve plexus of sigmoid between both groups( all P ﹥ 0. 05). Conclusion The local colon spasms of STC patients has relation with the further reduction of the number of ganglion cells in the enteric nervous system,and has less obvious relation with the quantitative of the nerve plexus.