小儿胆总管囊肿一氧化氮合酶的分布研究及临床应用

DISTRIBUTION AND CLINICAL APPLICATION OF NITRIC OXIDE SYNTHASE IN CHOLEDOCHOCYSTS

目的探讨NO在胆总管囊肿发病机制中的作用。方法用即用型SABC免疫组化染色方法检测先天性胆总管囊肿扩张段和狭窄段NOS的表达情况,并与5例无肝胆疾病的死亡小儿和4例引产死胎的正常胆总管NOS的表达情况进行比较。结果胆总管囊肿扩张段胆管,壁内神经丛神经元其分布和形态特征与正常对照组胆管相似,NOS表达活性较正常胆总管NOS表达活性略低,与对照组比较无显著性差异(P>0.05)。胆总管囊肿狭窄段肠管壁内含NOS表达阳性的神经元减少,肌层内NOS阳性神经纤维明显减少,NOS表达活性明显减弱,与扩张段和正常对照组胆总管比较,均有显著性差异(P<0.01)。结论胆总管囊肿狭窄段壁丛内缺失含NOS的神经元,肌层内NOS阳性神经纤维明显减少,酶活性明显减弱,提示NO分泌减少在胆总管囊肿的发病机制中起一定作用。

Objective To explore the functions of Nitric oxide （NO） in the pathogenic mechanism of choledochocyst. Methods Irnmunohistochemical staining method was used to examine the expressions of nitric oxide synthase（NOS） in the dilating and narrow segments of the common bile duct with congenital choledochocyst, the result of which was compared with the expressions in 5 children who died from hepatic and biliary disease and in 4 dead fetuses. Results the bile duct in the dilating segment and the distribution of neurons in intestinal wall were similar to normal ones. The activity of expressions of NO was slightly lower than normal ones （ P 〉 0.05）. NOS - positive neurons in the narrow segment, NOS - positive neural fibers and the activity of NOS ex- pressions all decreased significantly （ P 〈 0.01 ）. Conclusion The insufficient number of NOS- contained neurons, the decrease of NOS- positive nerve fibers and the decrease of enzymatic activity suggest that the decrease in the secretion of NO plays an important role in inducing choledochocyst.