伴结肠痉挛便秘患者肠壁神经特异性烯醇化酶和S-100的表达  

Expression of neuron-specific enolase and S-100 in constipation patients with spastic colon

作　　者：焦晗亮 孔利霞 宋建亭 赵士彭[1] 

机构地区：[1]河北医科大学第三医院,河北石家庄050051 [2]河北省武安市中医院,河北武安056300 [3]华北石油总医院,河北任丘062552

出　　处：《现代中西医结合杂志》2014年第24期2647-2650,2665,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的应用神经元特异性烯醇化酶(NSE)和S-100观察有肠道痉挛表现的便秘患者肠道神经丛及其组成成分有无异常改变,研究便秘患者结肠痉挛与肠神经系统可能存在的联系。方法采集手术患者乙状结肠与横结肠肠壁组织,以有肠管痉挛表现者19例作为实验组,无肠管痉挛表现者20例作为对照组,应用NSE、S-100对肠壁组织进行免疫组织染色,计数肠神经丛和神经节细胞数,并观察其状态变化。结果 NSE、S-100染色均显示实验组痉挛段肠管黏膜下神经丛及肌间神经丛内的神经节细胞数量均有下降(P均<0.05),神经丛数目无显著变化(P>0.05),横结肠段神经丛及神经节细胞数目均无显著性差异(P>0.05)。光镜下可见痉挛段结肠神经纤维紊乱增生,神经节细胞形态发生变化。结论便秘患者结肠痉挛与肠神经系统中神经节细胞数量、成熟程度改变有关,肠壁中增生紊乱的神经纤维也起到一定的作用;患者痉挛段肠管病理表现与巨结肠类缘病类似,患者无结肠扩张,可能与患者病变程度轻,近端结肠处于代偿期有关。Objective It is to the inspect composition of enteric plexus presence and whether or not there are changes in patients with constipation with the colon spasm by neuron-specific cnolase （NSE） and S - 100, and to explore the possible relationship between spastic colon and enteric nervous system. Methods The intestinal wall tissue were collected in the patients undergoing surgery in which 19 patients with spastic colon as the experimental group, 20 patients without bowel spasms as control group. NSE, S - 100 were used to perform intestinal wall tissue immunohistochemical staining, intestinal nerve plexus and ganglion cells were counted and its state changes were observed. Results Both NSE and S - 100 staining showed that ganglion cells of experimental group were decreased both in submucosalplexus and myenteric plexus of bowel segment（ P 〈 0.05 ） ,but no significant change of the number of nerve plexus was found（P 〉 0. 05 ）. There was no significant difference in the number of ganglion cells and nerve plexus in transverse section （ P 〉 0.05 ）. Nerve fiber disorders and hyperplasia and the morphology changes of ganglion could be found under light microscope. Conclusion Colon spasm in patients with constipation is related to number and ripeness of ganglion cell within enteric nervous system, diregular distribution and proliferation of nerve fibers also play some part in this development. Pathology in spastic bowel segment of the control group is similar with Hirschsprung allied disease, these patients without colonic dilatation may be associated with mild severity and （or） the proximal colon is in compensated stage.

关 键 词：结肠痉挛 便秘 肠神经系统 神经元特异性烯醇化酶 S-100 

分 类 号：R574.62[医药卫生—消化系统]