肥大细胞在先天性巨结肠症中的分布及其在发病机制中的作用

Distribution of mast cells and its role in the pathogenesis of Hirschsprung disease

目的探讨肥大细胞在先天性巨结肠症（HD）发病机制中的作用。方法采用鼠抗人肥大细胞类胰蛋白酶单克隆抗体．通过免疫组织化学SP法观察四川省人民医院普通外科2000年至2006年经手术治疗、病理资料完整的41例HD患儿和8例正常儿（对照组）的结肠内肥大细胞的分布情况及差异。结果光镜下观察肥大细胞主要分布于黏膜层及黏膜下层。无神经节结肠段（切除病变肠管远端）的肥大细胞计数为21．47±3．59，明显多于有神经节结肠段（切除病变肠管近端）的3．18±0．87及对照组结肠各层（尤其黏膜层及黏膜下层）的2．75±0．51（P〈0．01）。无神经节结肠段组肥大细胞吸光度（A）值为0．38±0．10．有神经节肠段组则为0.31±0．11，差异无统计学意义（P〉0．05）；但均明显少于对照组的0．51±0．08（P〈0．01）。结论肥大细胞可能在HD的发病机制中扮演重要角色。

Objective To investigate the distribution of mast cells （MC） in colon tissue of Hirschsprung disease（HD） and explore the role of mast cells in the pathogenesis of HD. Methods Forty-one cases of HD （male 23, female 18）, age from 2 months to 15 years, and eight age-matched normal cases were enrolled in this study. The distribution of MC in all layers of colon was examined by immunohistochemistry with mouse antihuman mast cell tryptase monoclonal antibody. Results The count of MC in all layers of colon aganglionic segments of HD was significantly higher as compared with colon ganglionic segments of HD and normal controls （21.47±3.59 vs 3.18±0.87, 2.75±0.51）. The average optical density values（A ） of MC in aganglionic and ganglionic segments significantly decreased as compared to normal control （0.38±0.10,0.31±0.11 vs 0.51±0.08）. Conclusion Mast cells may play an important role in the pathogenesis of HD.