先天性食管闭锁伴气管食管瘘大鼠模型研制及其病理组化研究  

Murine models of esophageal atresia and tracheoesophageal fistula: Methodology and pathology

作　　者：潘伟华[1] 施诚仁[1] 李敏[1] 张忠德[2] 

机构地区：[1]上海第二医科大学附属新华医院小儿外科,200127 [2]上海第二医科大学附属新华医院病理科,200127

出　　处：《中华小儿外科杂志》2002年第2期146-149,共4页Chinese Journal of Pediatric Surgery

摘　　要：目的　通过对怀孕大鼠腹腔注射阿霉素 ,制成食管闭锁及气管食管瘘胚胎大鼠模型 ,并就其适用性及解剖学特点进行了探讨。方法　在Wister大鼠怀孕第 8、9两天给予腹腔注射阿霉素 1.75mg/kg,对照组在相应孕期内注射相同剂量生理盐水 ,纪录孕期大鼠体重波动。第 2 1d剖腹取出胎鼠 ,体式显微镜下显微解剖确定是否存在食管闭锁及气管食管瘘 ,并检视其他系统脏器的发育情况 ,测量腹段食管长度 ,取出气管叉水平下段食管作组织病理检查。结果　显微解剖发现其腹段食管较短 ,提示EA TEF可能存在抗反流屏障的缺陷 ;HE及VG染色显示其远端食管有气管化倾向 ,粘膜呈假复层纤毛柱状上皮 ,肌层稀疏 ,排列紊乱 ,胶原显微增生 ,透射电镜显示近膈肌端食管环肌纤维中线粒体数量减少 ,对肌纤维的伸缩支持功能下降 ,提示EA TEF患儿食管壁结构可能存在先天性的异常 ,从而影响了食管正常的动力学功能 ;一氧化氮合成酶组织化学染色提示病变段食管壁中NOS分布密度增强 ,可能影响了正常的平滑肌舒张及食管蠕动功能 ;神经细胞粘附分子 (NCAM)免疫组织化学染色显示食管壁中NCAM呈高表达状态 ,提示EA TEF食管壁内神经肌肉接头呈未成熟状态 ,影响了正常的神经 -肌肉联系 ,导致食管动力学功能异常。结论　EA TEF胎鼠的食管壁发育不成熟 ,Objective To investigate the pathohistologic characteristics of murine models of esophageal atresia(EA) and tracheoesophageal fistula(TEF).Methods Adriamycin was administered to time mated pregnant Wister rats intraperitoneally ( 1.75 ?mg/kg)at gestational day 8 and 9. The rats were killed on day 21 of gestation. The litters developed EA TEF.Results Abdominal esophagus was found to be shorter in the EA fetuses than that of the sham or control groups, which suggests a defect in anti reflux defense in EA TEF. Tracheobronchial elements were observed along the distal esophagus and collagen fibers were more prominent in the EA fetuses, indicating that the esophageal structure may originate congenitally in EA TEF. The mitochondria distribution was irregular in the circular muscle cells at diaphragmatic level in the esophagus of EA group. Density of NOS distributed in the esophageal wall was increased in EA group than that in the controls. Immunoactivities to the NCAM were observed at a high level in the esophagus of the EA fetuses.Conclusions Consisting of the tracheogenic histologic structures and decreasing in mitochondria distrbution in the circular muscle cells at diaphragmatic level of the esophagus of EA fetuses, which might interfere with the normal relaxation and peristalsis of the esophagus and lead to esophageal motility disturbances.

关 键 词：先天性食管闭锁 免疫组织化学 气管食管瘘 实验研究 大鼠模型 

分 类 号：R-332[医药卫生]