先天性肥厚性幽门狭窄一氧化氮合成酶及肠间质细胞的免疫组化研究

目的:了解先天性肥厚性幽门狭窄(CHPS)与一氧化氮(NO)及肠间质细胞(ICs)的关系,以进一步研究 CHPS 的发病机理。方法:通过还原型辅酶Ⅱ二磷酸酶组织化学及酪氨酸激酶受体(c-kit)免疫组化方法观察了一氧化氮合成酶(NOS)及 ICs 在27例 CHPS 及12例正常对照组幽门肌中的分布情况。结果:对照组幽门环肌层内含有丰富的 NOS 染色阳性神经纤维,肌间神经丛及粘膜下神经丛神经元呈 NOS 染色阳性,纵肌层 NOS 染色阳性神经纤维明显少于环肌层;多量ICs 分布于肌间神经节周围和环肌层内,并联结成网状结构。在 CHPS 幽门环肌层中缺乏 NOS 染色阳性神经纤维,纵肌层内 NOS 染色阳性神经纤维较对照组减少,而肌间神经丛神经元则呈NOS 染色阳性;在 CHPS 肥厚的环肌层内及肌间神经节周围几乎无 ICs,仅见有少量 ICs 残留在粘膜下之浅表环肌层内。结论:NOS 及 ICs 的异常分布可能与 CHPS 的发病机理有关。

Nitric oxide synthase distribution in the enteric nervous system of children with cardiac achalasia

Objective To study the distribution of nitric oxide synthase (NOS) in the enteric nervous system of children with cardiac achalasia. Methods Biopsy specimens of the lower esophagus, cardia, gastric fundus and pylorus from 13 patients with cardiac achalasia and 6 controls were obtained and studied histochemically with nicotinamide adenine dinucleotide phosphate diaphorase (NADPH d) and immunohistochemically with a specific polyclonal antiserum. Results NOS was abundant in the myenteric plexus and the nerve fibers of musculatures in the esophagus, cardia and gastric fundus in control group, while it was nearly absent in the patient group. The distribution of NOS in the pylorus was similar in the two groups. Conclusion These findings suggest that a lack of NOS in the lower esophagus, cardia and gastric fundus is involved in the pathophysiology of cardiac achalasia in children.