一氧化氮在先天性巨结肠肠粘膜和血中的改变

STUDIES ON NITRIC OXIDE IN INTESTINAL MUCOSA AND PLASMA IN HIRSCHSPRUNG DISEASE

目的 通过测定肠粘膜和血中一氧化氮 (NO)的改变 ,探讨先天性巨结肠 (HD)病理生理变化和先天性巨结肠合并小肠结肠炎的原因。方法 比色法测定 2 5例HD、30例非HD患者肠粘膜中一氧化氮合酶 (NOS)和手术前后血中NO含量。结果 ①HD粘膜层中NOS含量狭窄段组较扩张段组低 ,2组间差异有显著性 (P <0 .0 5 )。②HD狭窄段粘膜层中NOS含量较非HD粘膜层中NOS含量低 ,2组间差异有显著性 (P <0 .0 5 )。③HD术前组较非HD组血中NO含量明显减低 ,2组间差异有显著性 (P <0 .0 5 )。④HD术后组较非HD组血中NO含量明显减低 ,2组间差异有显著性 (P <0 .0 5 )。结论 HD病人血中NO含量减少、狭窄段肠粘膜NOS活性降低是HD易合并小肠结肠炎的重要原因之一。NO制剂可能为临床上预防和治疗HD合并小肠结肠炎开辟一条新的途径。

Objective To understand the potential relationship between nitric oxide (NO) and Hirschsprung disease(HD). Methods NO level in plasma and NOS level in intestinal mucosa were evaluated in 25 cases of HD.30 age-matched children served as control. Mucosal NOS activity was measured using spectrophotometry and NO of plasma was measured using Hegesh method. Results ①Mucosal NOS activity was significantly lower in aganglionic segments than that of ganglionic segments with HD. ②Mucosal NOS activity was significantly lower in aganglionic segments than that of non-HD. ③Preoperative plasma NO levels was significantly lower in HD than that in non-HD. ④Postoperative plasma NO levels was significantly lower in HD than that in non-HD. Conclusion It is postulated that reduction of NO in plasma and intestinal mucosa might be responsible for HD to be susceptible to infection, hence to induce enterocolitis. NO may be a new way for prevention and treatment of HD induced enterocolitis.