现代中西医结合杂志
現代中西醫結閤雜誌
현대중서의결합잡지
MODERN JOURNAL OF INTEGRATED TRADITIONAL CHINESE AND WESTERN MEDICINE
2014年
24期
2627-2630,2665
,共5页
焦晗亮%孔利霞%宋建亭%赵士彭
焦晗亮%孔利霞%宋建亭%趙士彭
초함량%공리하%송건정%조사팽
结肠痉挛%便秘%肠神经系统%神经元特异性烯醇化酶%S-100
結腸痙攣%便祕%腸神經繫統%神經元特異性烯醇化酶%S-100
결장경련%편비%장신경계통%신경원특이성희순화매%S-100
spastic colon%constipation%enteric nervous system%neuron-specific enolase%S-100
目的：应用神经元特异性烯醇化酶（ NSE）和S-100观察有肠道痉挛表现的便秘患者肠道神经丛及其组成成分有无异常改变，研究便秘患者结肠痉挛与肠神经系统可能存在的联系。方法采集手术患者乙状结肠与横结肠肠壁组织，以有肠管痉挛表现者19例作为实验组，无肠管痉挛表现者20例作为对照组，应用NSE、S-100对肠壁组织进行免疫组织染色，计数肠神经丛和神经节细胞数，并观察其状态变化。结果 NSE、S-100染色均显示实验组痉挛段肠管黏膜下神经丛及肌间神经丛内的神经节细胞数量均有下降（P均＜0．05），神经丛数目无显著变化（P＞0.05），横结肠段神经丛及神经节细胞数目均无显著性差异（P＞0.05）。光镜下可见痉挛段结肠神经纤维紊乱增生，神经节细胞形态发生变化。结论便秘患者结肠痉挛与肠神经系统中神经节细胞数量、成熟程度改变有关，肠壁中增生紊乱的神经纤维也起到一定的作用；患者痉挛段肠管病理表现与巨结肠类缘病类似，患者无结肠扩张，可能与患者病变程度轻，近端结肠处于代偿期有关。
目的：應用神經元特異性烯醇化酶（ NSE）和S-100觀察有腸道痙攣錶現的便祕患者腸道神經叢及其組成成分有無異常改變，研究便祕患者結腸痙攣與腸神經繫統可能存在的聯繫。方法採集手術患者乙狀結腸與橫結腸腸壁組織，以有腸管痙攣錶現者19例作為實驗組，無腸管痙攣錶現者20例作為對照組，應用NSE、S-100對腸壁組織進行免疫組織染色，計數腸神經叢和神經節細胞數，併觀察其狀態變化。結果 NSE、S-100染色均顯示實驗組痙攣段腸管黏膜下神經叢及肌間神經叢內的神經節細胞數量均有下降（P均＜0．05），神經叢數目無顯著變化（P＞0.05），橫結腸段神經叢及神經節細胞數目均無顯著性差異（P＞0.05）。光鏡下可見痙攣段結腸神經纖維紊亂增生，神經節細胞形態髮生變化。結論便祕患者結腸痙攣與腸神經繫統中神經節細胞數量、成熟程度改變有關，腸壁中增生紊亂的神經纖維也起到一定的作用；患者痙攣段腸管病理錶現與巨結腸類緣病類似，患者無結腸擴張，可能與患者病變程度輕，近耑結腸處于代償期有關。
목적：응용신경원특이성희순화매（ NSE）화S-100관찰유장도경련표현적편비환자장도신경총급기조성성분유무이상개변，연구편비환자결장경련여장신경계통가능존재적련계。방법채집수술환자을상결장여횡결장장벽조직，이유장관경련표현자19례작위실험조，무장관경련표현자20례작위대조조，응용NSE、S-100대장벽조직진행면역조직염색，계수장신경총화신경절세포수，병관찰기상태변화。결과 NSE、S-100염색균현시실험조경련단장관점막하신경총급기간신경총내적신경절세포수량균유하강（P균＜0．05），신경총수목무현저변화（P＞0.05），횡결장단신경총급신경절세포수목균무현저성차이（P＞0.05）。광경하가견경련단결장신경섬유문란증생，신경절세포형태발생변화。결론편비환자결장경련여장신경계통중신경절세포수량、성숙정도개변유관，장벽중증생문란적신경섬유야기도일정적작용；환자경련단장관병리표현여거결장류연병유사，환자무결장확장，가능여환자병변정도경，근단결장처우대상기유관。
Objective It is to the inspect composition of enteric plexus presence and whether or not there are changes in patients with constipation with the colon spasm by neuron-specific enolase (NSE) and S-100, and to explore the possible re-lationship between spastic colon and enteric nervous system .Methods The intestinal wall tissue were collected in the patients undergoing surgery in which 19 patients with spastic colon as the experimental group , 20 patients without bowel spasms as con-trol group .NSE, S-100 were used to perform intestinal wall tissue immunohistochemical staining , intestinal nerve plexus and ganglion cells were counted and its state changes were observed. Results Both NSE and S-100 staining showed that ganglion cells of experimental group were decreased both in submucosal plexus and myenteric plexus of bowel segment (P<0.05),but no significant change of the number of nerve plexus was found (P>0.05 ).There was no significant difference in the number of ganglion cells and nerve plexus in transverse section (P>0.05).Nerve fiber disorders and hyperplasia and the morphology changes of ganglion could be found under light microscope .ConclusionColon spasm in patients with constipation is related to number and ripeness of ganglion cell within enteric nervous system , diregular distribution and proliferation of nerve fibers also play some part in this development .Pathology in spastic bowel segment of the control group is similar with Hirschsprung allied disease, these patients without colonic dilatation may be associated with mild severity and (or) the proximal colon is in com-pensated stage .
