乙状结肠代阴道成形术后黏膜的形态学改变及神经型一氧化氮合酶表达的研究  

Morphologic change and expression of neuronal nitric oxide svnthase in neovaginal mucosa of patients undergoing vaginal construction with sigmoid colon

作　　者：黄向华[1] 高志敏[1] 张琳[1] 王振海[1] 朱志洁[1] 

机构地区：[1]河北医科大学第二医院妇产科,石家庄050000

出　　处：《中华医学杂志》2007年第41期2905-2908,共4页National Medical Journal of China

摘　　要：目的观察乙状结肠代阴道成形术后黏膜的形态学改变及黏膜内神经型一氧化氮合酶(nNOS)表达的变化。方法对14例代阴道的乙状结肠黏膜及14例正常乙状结肠黏膜标本应用光镜、电镜进行形态学检查,采用免疫组化方法对黏膜的 nNOS 表达进行半定量研究。结果乙状结肠代阴道成形术后人工阴道上段黏膜肌层增生肥厚,黏膜下层神经丛密度增加(3.6±1.5 vs 1.7±0.8,P<0.05);部分下段黏膜有鳞状上皮化生。电镜见代阴道结肠黏膜杯状细胞的分泌泡较少,上皮细胞间紧密连接有部分融合,粗面内质网有脱颗粒现象。代阴道乙状结肠黏膜上皮、黏膜腺体内nNOS 的表达较正常乙状结肠黏膜减弱。结论乙状结肠代阴道成形术后黏膜发生了形态学改变,以下段变化明显。Objective To study the changes of the histology and expression of neuronal nitric oxide synthase （nNOS） in the neovaginal mucosa of the patients undergoing vaginal construction with sigmoid colon. Methods Biopsy samples of upper one-third and lower one-third of the artificial vagina were obtained from 14 patients who underwent vaginal construction with sigmoid colon 9 -48 months before and samples of normal sigmoid colon were collected from another 14 patients during vaginal construction with sigmoid colon as control group. The pathological and ultrastructural changes were comparatively observed by light microscopy and electron microscopy. At the same time, the expression of nNOS was semiquantitatively evaluated with immunohistochemical method. Results The upper one-third of the artificial vagina muscular layer of mucosa was hyperplastic and hypertrophic and the density of the submucosal nerve plexus was 3.6 ± 1.5, significantly higher than that of the control group （ 1.7 ±0.8, P 〈 0.05 ）. Squamous metaplasia was seen in the colonic mucosa from some 3 samples of lower one-third of the artificial vagina. Partial fusion of the intercellular tight junction, disappearance and fusion of mitochondrial cristae, and degranulation of rough endoplasmic reticulum could be seen in the vaginal colonic mucosa. Compared with the normal control, the expression of nNOS in the vaginal colonic mucosa was significantly decreased. Condusion Morphologic changes occur nNOS expression decreases in the colonic mucosa of the artificial vagina.

关 键 词：阴道 人工 乙状结肠 黏膜 一氧化氮合酶 

分 类 号：R713[医药卫生—妇产科学]