Ⅰ型、Ⅲ型胶原在老年传输功能障碍性结肠便秘患者检测中的临床意义

Clinical significance of the detection of type Ⅰ and type Ⅲ collagen in elderly patients with transmission dysfunctional colonic constipation

目的Ⅰ型、Ⅲ型胶原在老年传输功能障碍性结肠便秘患者检测中的临床意义。方法选择2014年1月至2016年12月手术切除结肠的老年传输功能障碍性便秘30例为观察组。选择同期行结肠手术治疗,非便秘性老年患者30例为对照组。观察2组结肠组织HE染色,2组黏Ⅰ型、Ⅲ型胶原免疫组织化学和天狼星红染色观察表达情况进行比较。结果对照组未见明显的炎性反应,未发现黏膜下层和肌间神经丛病变的发生。观察组可见黏膜层明显的慢性炎性反应,见大量的嗜酸性粒细胞浸润,主要集中在固有膜中,黏膜下肌层明显增厚,胶原纤维化;肌层胶原纤维明显增生,肌间神经丛细胞空泡变性和减少。免疫组织化学结果显示观察组Ⅰ型、Ⅲ型胶原表达的IOD值明显高于对照组,差异有统计学意义(P <0. 01)。苦味酸天狼星红染色结果显示观察组的Ⅰ型胶原纤维明显较对照组明显降低(P <0. 01),而Ⅲ型胶原表达面积百分比明显高于对照组(P <0. 01)。结论老年传输功能障碍性结肠便秘患者结肠壁I型、Ⅲ型胶原出现明显增多,其中以Ⅲ型胶原增加更为明显,对该疾病的诊断和治疗提供重要的参考。

Objective To investigate the clinical significance of the detection of typeⅠand typeⅢcollagen in elderly patients with transmission dysfunctional colonic constipation.Methods A total of 30 elderly patients with transmission dysfunctional colonic constipation who underwent colon exairesis in our hospital from January 2014 to December 2016 were enrolled as observation group,at the same time,the other 30 elderly patients without constipation were enrolled as control group.The HE staining of colon tissue,the expression of typeⅠand typeⅢcollagen detected by immunohistochemistry or by Sirius Red staining were observed and compared between the two groups.Results There were no obvious inflammatory reaction and no submucosal and myenteric plexus lesion in control group.There were obvious chronic inflammatory reaction in mucous layer in observation group,and a large number of eosinophil infiltration mainly concentrated in the lamina propria,moreover there were submucosal muscle thickened obviously,collagen fibrosis,myometrial collagen fibers distinct hyperplasia,myenteric nerve plexus cellular vacuolization and reduction.The immunohistochemistry result showed that IOD value of typeⅠand typeⅢcollagen expressions in observation group were significantly higher than those in control group(P<0.01).The staining of melinite and Sirius red showed that typeⅠcollagen fibers in observation group were significantly lower than those in control group(P<0.01),however the percentage of typeⅢcollagen expression area was significantly higher than that in control group(P<0.01).Conclusion There is a significant increase in collagen typeⅠand typeⅢcollagen in elderly patients with transmission dysfunctional colonic constipation,in which,the increase of typeⅢcollagen is more obvious,which provides an important reference for the diagnosis and treatment of the disease.