先天性巨结肠突触素免疫组织化学探究.docVIP

先天性巨结肠突触素免疫组织化学探究 　 作者：崔新海 陈雨历 张蕾 张唐山 刘园园 【摘要】目的：采用突触素免疫组织化学方法，对先天性巨结肠神经肌肉连接进行研究，并探讨其与先天性巨结肠发病的关系。方法：应用免疫组化技术对20例先天性巨结肠病变肠段及10例正常结肠组织标本行突触素神经肌肉连接标记，光镜下观察其免疫反应。结果：对照组的结肠突触素免疫反应呈强阳性表达，先天性巨结肠组扩张肠段突触素免疫反应呈阳性或弱阳性表达，狭窄段肠壁突触素免疫反应呈阴性表达。结论：先天性巨结肠病变肠段同时缺乏内源性神经支配和外源性神经支配，处于完全失神经支配状态，导致原神经节细胞病变肠管功能障碍。 【关键词】巨结肠，先天性#12539;突触素 【ABSTRACT】Objective:To study the neuromuscular junction of the colon in patients with Hirschsprungs disease by immunohistochemical methods.Methods:The distribution of the neuromuscular junction in the muscle layers of bowel from 10 normal controls and 20 Hirschsprung?s disease patients was studied by synaptophysin immunohistochemistry.Antimouse synaptophysin serum was used for visualization of neuromuscular junction.Results:In the colon of the control cases，synaptophysinimmunoreactivity was widely distributed in the circular muscle layer.In the dilated colon with Hirschsprung’s disease cases,synaptophysinimmunoreactivity was moderately distributed within normal ganglion cell and scarcely in constricted segment within degenerated ganglion cell.In contrast to the high degree of synaptophysinimmunoreactivity in the controls and dilated colon,the synaptophysinimmunoreactivity in the constricted segment were nil in the circular muscle layer.Conclutions:Dense synaptophysinimmunoreactivity nerve endings were prominent in the circular muscle layer in the control and there was almost no synaptophysin imm〖HK140mm]unoreactivity activity in the circular muscle layer in the constricted segment.The circular muscle layer from the constricted segment is confirmed to be a region with poor innervation including extrinsic and intrinsic nerve.Based on the Cannon?s Law of Denervation,the muscles that are supplied by these nerves shorten and tighten,resulting in muscle spasm and stiffness.The constricted segment which was denervated,is incapable of transmitting normal propulsive peristaltic waves and therefore acts as a physiologic obstruction. 【KEY WORDS】Hirschsprung’s disea