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目的:了解先天性肥厚性幽门狭窄(CHPS)与一氧化氮(NO)及肠间质细胞(ICs)的关系,以进一步研究 CHPS 的发病机理。方法:通过还原型辅酶Ⅱ二磷酸酶组织化学及酪氨酸激酶受体(c-kit)免疫组化方法观察了一氧化氮合成酶(NOS)及 ICs 在27例 CHPS 及12例正常对照组幽门肌中的分布情况。结果:对照组幽门环肌层内含有丰富的 NOS 染色阳性神经纤维,肌间神经丛及粘膜下神经丛神经元呈 NOS 染色阳性,纵肌层 NOS 染色阳性神经纤维明显少于环肌层;多量ICs 分布于肌间神经节周围和环肌层内,并联结成网状结构。在 CHPS 幽门环肌层中缺乏 NOS 染色阳性神经纤维,纵肌层内 NOS 染色阳性神经纤维较对照组减少,而肌间神经丛神经元则呈NOS 染色阳性;在 CHPS 肥厚的环肌层内及肌间神经节周围几乎无 ICs,仅见有少量 ICs 残留在粘膜下之浅表环肌层内。结论:NOS 及 ICs 的异常分布可能与 CHPS 的发病机理有关。
Objective: To investigate the relationship between congenital hypertrophic pyloric stenosis (CHPS) and nitric oxide (NO) and interstitial cells (ICs) in order to further study the pathogenesis of CHPS. Methods: The expressions of nitric oxide synthase (NOS) and ICs in 27 CHPS patients and 12 normal controls were observed by histochemical staining of reduced coenzyme Ⅱ diphosphatase and c-kit immunohistochemistry Pyloric muscle distribution. Results: NOS positive nerve fibers were abundant in pyloric ring muscle of control group. NOS positive neurons were found in myenteric plexus and submucosal plexus plexus. NOS positive nerve fibers in longitudinal muscle were significantly less than those in the muscular lamina propria. ICs are distributed around the myenteric ganglion and within the muscularis propria and are networked together into a network. NOS positive nerve fibers were absent in the pyloric ring of CHPS, NOS positive nerve fibers in the longitudinal muscle layer were decreased compared with the control group, while the myenteric plexus neurons were positive for NOS staining. In CHPS hypertrophic ring myometrium and There were almost no ICs around the myenteric ganglion, and only a small amount of ICs remained in the submucous superficial myometrium. Conclusion: The abnormal distribution of NOS and ICs may be related to the pathogenesis of CHPS.