克隆病P物质阳性神经组织及肥大细胞的形态学观察

Morphologic Observation of Substance P-containing Neural Tissues and Mast Cells in Crohn's Disease

观察克隆病时Ｐ物质阳性神经组织、肥大细胞形态变化，并探讨其在该病发病中的作用。方法：应用免疫组织化学、组织化学方法对２７例克隆病（回肠１４例，结肠１３例），１０例对照组肠壁Ｐ物质（ＳＰ）阳性神经纤维、神经元及肥大细胞进行观察。用形态计量学方法计量ＳＰ阳性神经组织的体密度及肥大细胞密度。结果：克隆病时肠壁粘膜下层神经纤维增生，部分呈“神经瘤样”改变，ＳＰ阳性神经元数量增多。粘膜下层及肌间神经丛ＳＰ阳性神经组织体密度与对照组相比有显著性差异（Ｐ＜０．０１，Ｐ＜０．０５）。粘膜下层小血管周围有较多ＳＰ阳性神经纤维分布并与血管壁接触。粘膜下层与肌层肥大细胞密度均较对照组增加（Ｐ＜０．０５，Ｐ＜０．０１）。结论：ＳＰ阳性神经组织通过调节小血管反应，及肥大细胞在克隆病发病中发挥一定作用。

To investigate the effect of substance P(SP)-positive neural tissues and mast cell in the pathogenesis of Crohn's disease by observation of morphological changes of SP--containing neural tissues and mast cell. Methods: Histochemical and immunohistochemical techniques were applied to study the SP-containing neural tissues and mast cell in intestine from 27 cases of Crohn's disease(ileum n = 14, colon n = 13). The volumetric density(Vv)of SP-containing neural tissues were measured by morphometry. The mast cells were counted per unit area. Results: The SP-containing nerve fibers in the submucosa of Crohn's disease showed marked hyperplasia. Tortuous nerve bundles(so called'neuromatoid'lesions ) were seen. Many SP-containing nerve fibers could be seen in close connection with small blood vessels. The number of SP-containing neurons were increased. The Vv of SP--containing neurons and nerve fibers in submucosa and plexsus myoentericus were significantly higher than those in the controls(P < 0. 01, P < 0. 05 ). Mast cells were present in a greater number in submucosa and muscularis propria(P < 0. 05, P < 0. 01 ). Conclusion: The results suggested that SP may play a role in the pathogenesis of Crohn's disease.