儿童贲门失弛缓症一氧化氮合成酶的免疫组化研究

Immunohistochemical Study of Nitric Oxide Synthase in Children with Achalasia

目的:研究一氧化氧合成酶(NOS)在儿童贲门失弛缓症肠神经系统中的分布。方法:应用还原型辅酶Ⅱ二磷酸酶组织化学及 NOS 免疫组化方法观察13例儿童贲门失弛缓症及6例对照组远端食管、贲门、胃底及幽门部 NOS 的分布情况。结果:对照组食管、贲门、胃底及幽门部肌层内含有丰富的 NOS 染色阳性神经纤维,肌间神经节细胞呈 NOS 染色阳性。患儿组贲门部肌层中缺乏 NOS 染色阳性神经纤维,肌间神经节细胞呈 NOS 染色阴性,远端食管及胃底部偶可见散在的 NOS 染色阳性神经节细胞,幽门部 NOS 的分布与对照组基本相同。结论:远端食管、贲门及胃底部缺乏 NOS 可能与功能性贲门失弛缓症发病的病理生理有关。

Objective:To study the distribution of nitric oxide synthase(NOS)in the enteric nervous system of children with achalasia.Methods:Biopsy specimens of the lower esophagus, cardia,gastric fundus and pylorus were obtained from 13 children with achalasia and 6 children as control.The specimens were studied histochemically with nicotinamide adenine dinueleotide phos- phate diaphorase(NADPH-d)and immunohistochemically with a specific polycolonal antiserum. Results:NOS was abundant in the myenteric plexus and nervous fibers of musculature in esopha- gus,cardia and gastric fundus in control group,while it was almost absent in the achalasia group. Only a few NOS positive cells appeared sparsely in the distal esophagus and gastric fundus in acha- lasia group.The distributions of NOS in the pylorus were similar in both groups.Conclusion: Lack of NOS in the lower esophagus,cardia and gastric fundus is an important pathophysiological character of achalasia in echildren.