急性肾功能衰竭大鼠肠神经系统病理改变及诱导型一氧化氮合酶的免疫组化分析

Pathological Change in Rats'Intestinal Nervous System With Acute Renal Failure and Immunohistochemical Analysis of iNOS

目的 了解急性肾功能衰竭的肠神经系统 (ENS)改变。方法 建立急性肾衰模型 ,成功后第 4d处死大鼠 ,抽取眼内眦血 ,测定血总肌酐、尿素氮。取肾组织及大鼠十二指肠、空肠、回肠、结肠、直肠分别行HE染色及iNOS(诱导型一氧化氮合酶 )免疫组化染色 ,观察ENS神经丛及神经元的数量、iNOS阳性细胞神经丛数量及黏膜上皮有无充血水肿、变性坏死、炎细胞浸润。结果 ⑴共 10例肾衰鼠均出现肾小管变性坏死 ,可见透明管型 ,间质出血坏死、炎细胞浸润。⑵ENS神经丛及神经元的数量较正常组减少 ,其中以回肠和直肠改变尤为明显。⑶ENS中iNOS阳性细胞神经丛数量较正常组明显减少 ,iNOS阳性表达较正常组强。结论 提示尿毒症代谢产物作用于肠神经系统 ,导致ENS病变而出现胃肠运动功能异常。

Objective To understand the intestinal nervous system(ENS) pathological change in rats with acute renal failure(ENS).Methods Rat acute renal failure model was established,the intracanthus blood was drew to determine the serum total creatinine(Scr) blood urea nitrogen(BUN) after 48h and 4th-day,then the rats was sacrificed at fourth day each rat's kidney tissue,duodenum,jejunum,ileum,colon and rectum were stained with hematoxylineosin(SE).Finaly, iNOS staining by immunohitochemstry,observed the numbers of the ENS nerve plexus, ENS nerve cell , and iNOS positive cell nerve plexus. Check whether there has hyperemia hydrops, degenerative necrosis, and inflammatory cell infiltration on the mucosa epithelium.Results ⑴Kidney histological change was occurred. The kidney tubules degenerative necrosis was found in all the ten cases of kidney failure, and the hyaline cast, mesenchyme hemorrhagic necrosis, and inflammatory cell infltration were seen. ⑵ HE coloration and microscope inspection;numbers of the ENS nerve plexus and nerve cell of the acute kidney failure group were less than the normal group, especially in the ileum and rectum .⑶The number of the iNOS positive cell nerve plexus in ENS of the rats with acute renal failure was apparently less than that of the normal group. In addition, the iNOS positive presentation was stronger than that of the normal group.Conclusions The findings suggest that toxic metabolites of uremic rat acts on the ENS,and thus leading to pathological changes of ENS,resulting in stomach and intestinal mortor function disorder.