运动迟缓型便秘结肠神经系统胃泌素和P物质的分布观察

OBSERVATION OF GASTRIN AND SUBSTANCE P IN THE NERVOUS SYSTEM OF INTESTINE IN PATIENTS WITH DELAYED MOTOR CONSTIPATION

目的 探讨结肠壁内肌间神经丛和粘膜下神经丛胃泌素和P物质 (SP)在运动迟缓型便秘 (DMC)中的神经病理变化。方法 应用胃泌素和P物质的兔多克隆抗体 ,对手术切除的 10例DMC患者的结肠不同段和 8例正常结肠的神经丛内胃泌素和P物质进行免疫组化研究和相对半定量比较。结果 DMC患者结肠肌间神经丛胃泌素和SP免疫反应阳性神经细胞明显减少 ,与正常结肠比较 ,差异有显著性意义 (P <0 0 1) ,粘膜下神经丛胃泌素和SP免疫反应阳性神经细胞两组间差异无显著性意义 (P >0 0 5 )。常规HE染色下 ,DMC结肠粘膜下有灶状炎症 ,肌间神经丛神经元空泡变性、减少 ,甚至消失。结论 DMC患者结肠壁内存在明显的神经结构变化 ,其运动迟缓可能与肠壁内胃泌素和SP肽能神经元数量减少或功能障碍有关。

Objective\ To study the neuropathological changes of gastrin and substance P(SP) in the intermuscular and submucous nerve plexus of the colonic walls in patients with delayed motor constipation(DMC). Methods\ Gastrin and rabbit SP polyclonal antibiotics were used to make an immunohistochemical staining of the samples of different segments obtained from 10 patients with DMC and 8 normal subjects(control group) for a comparative observation as well as a relative semi quantitative analysis. Results\ The immune positive nerve cells of gastrin and SP in the intermuscular nerve plexus of colon with DMC were markedly reduced; no differences in the immune response of gastrin and SP in the mucous nerve plexus were found between the two groups( P<0 01) . With routine HE staining, focal inflammation occurred in the mucous membrane of DMC colon and that the neuronal vacuolus of the intermuscular nerve plexus degenerated, reduced and even disappeared. Conclusion\ The abnormal changes of the neural structure in the immune reponse of gastrin and SP in the intermuscular nerve plexus of colon with DMC might be related to reduction of gastrin and SP peptide neuron or dysfunctional.