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目的 了解急性肾功能衰竭的肠神经系统 (ENS)改变。方法 建立急性肾衰模型 ,成功后第 4d处死大鼠 ,抽取眼内眦血 ,测定血总肌酐、尿素氮。取肾组织及大鼠十二指肠、空肠、回肠、结肠、直肠分别行HE染色及iNOS(诱导型一氧化氮合酶 )免疫组化染色 ,观察ENS神经丛及神经元的数量、iNOS阳性细胞神经丛数量及黏膜上皮有无充血水肿、变性坏死、炎细胞浸润。结果 ⑴共 10例肾衰鼠均出现肾小管变性坏死 ,可见透明管型 ,间质出血坏死、炎细胞浸润。⑵ENS神经丛及神经元的数量较正常组减少 ,其中以回肠和直肠改变尤为明显。⑶ENS中iNOS阳性细胞神经丛数量较正常组明显减少 ,iNOS阳性表达较正常组强。结论 提示尿毒症代谢产物作用于肠神经系统 ,导致ENS病变而出现胃肠运动功能异常。
Objective To understand the changes of enteric nervous system (ENS) in acute renal failure. Methods Acute renal failure model was established. On the 4th day after the successful operation, rats were sacrificed, blood from the eyes was collected, total creatinine and urea nitrogen were measured. The kidneys and rat duodenum, jejunum, ileum, colon, rectum, respectively, HE staining and iNOS (inducible nitric oxide synthase) immunohistochemical staining to observe the number of ENS plexus and neurons, iNOS positive The number of cellular nerve plexus and mucosal epithelium without congestion and edema, degeneration and necrosis, inflammatory cell infiltration. Results (1) A total of 10 cases of renal failure rats showed renal tubular degeneration and necrosis, visible transparent tube, interstitial hemorrhage necrosis, inflammatory cell infiltration. ⑵ENS nerve plexus and neurons than the normal group to reduce the number, of which the ileum and rectal changes are particularly evident. ⑶ENS the number of iNOS-positive cells in the CNS significantly decreased compared with the normal group, iNOS positive expression was stronger than the normal group. Conclusion prompted uremic metabolites in the enteric nervous system, leading to ENS lesions and abnormal gastrointestinal motility.