先天性巨结肠粘膜肌和Meissener's神经丛病变  

Pathlological changes of muscularis's mucosae and Meissener's plexus in Hirschsprung’s disease

作　　者：胡家高[1] 鲁建生[2] 江泽熙[1] 申漫里 冯亭[2] 王竟春[2] 

机构地区：[1]武汉市儿童医院外科,430016 [2]武汉市儿童医院病理科,430016

出　　处：《中华小儿外科杂志》2000年第1期35-37,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的　探讨先天性巨结肠（ＨＤ） 粘膜肌有关病变特点、规律及Ｍｅｉｓｓｅｎｅｒ’ｓ 神经丛的分布。方法　对１８ 例先天性巨结肠手术切除标本沿系膜侧纵行、全段、不间断取材、切片，均做ＨＥ、ＶＧ、Ｆｏｏｔ’ｓ 网状纤维、弹力纤维、ＰＡＳ染色和免疫组化αＳＭａｃｔｉｎ 、ＮＦ、ＧＦＡＰ、ＮＳＥ等。观察肠粘膜层中肌动蛋白、网状纤维、弹力纤维的变化，及其Ａｕｅｒｂａｃｈ’ｓ 神经丛与Ｍｅｉｓｓｅｎｅｒ’ｓ 神经丛的分布与关系。结果　先天性巨结肠粘膜肌病变表现为：狭窄段粘膜平滑肌肌动蛋白减少或消失，网状纤维、弹力纤维网络状结构变形、塌陷以至消失，其减少程度和分布变化与神经丛、神经节细胞缺如相关。观察到神经纤维粗大的Ａｕｅｒｂａｃｈ’ｓ 神经丛沿环状肌束间隙，到达粘膜下层，过渡为病态的Ｍｅｉｓｓｅｎｅｒ’ｓ神经丛组织学图像。结论　ＨＤ无神经节细胞段粘膜肌肌动蛋白异常、减少或消失与Ｍｅｉｓｓｅｎｅｒ’ｓ 神经丛异常有关； ＨＤ无神经节细胞肠段系结肠神经发育障碍，其形态特点与年龄无明显关系。s Objective To study the changes of muscularis mucosae and Meissener's plexus in Hirschsprung's disease.Methods Serial sections were performed on 18 Hirschsprung’s disease specimens. The sections were immunostained for VG, Foot's, reticular and elastic fibers, PAS, alpha SM actin, NF, GFAP, NSE. Results The alpha SM actin was reduced in muscularis mucosae. The reticular and elastic fibers net were deformed. The degree of abnormality correlated with the deficiency of ganglion cells. Auerbach's plexus migrate from circular muscle to submucosal and became the pathological Meissener's plexus. Conclusion The change of actin of muscularis mucosae may be related to the abnormal Meissener's plexus in the aganglionic segment of Hirschsprung's disease.

关 键 词：HIRSCHSPRUNG病 肠粘膜 神经节丛病变 巨结肠 

分 类 号：R726.5[医药卫生—儿科]