神经生长因子及其受体在先天性肛门直肠畸形患儿直肠末端表达的下调  被引量:2

Expression of nerve growth factor and its receptor in distal rectum of children with anorectal malformations

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作  者:高明娟[1] 刘远梅[1] 毛羽晨[1] 金祝[1] 郑泽兵[1] 曲颜[1] 孔萌[1] 

机构地区:[1]遵义医学院附属医院小儿普胸泌外科,563003

出  处:《中华小儿外科杂志》2014年第9期698-702,共5页Chinese Journal of Pediatric Surgery

基  金:国家自然科学基金(81360067);贵州省社发公关项目(黔科普外字[2009]3079)

摘  要:目的观察神经生长因子(nerve growth factor,NGF)及其受体(TrkA、P75NTR)在先天性肛门直肠畸形(anorectal malformation,ARM)患儿直肠末端的表达,探讨对其肠神经系统发育的影响。方法收集2011年1月至2013年1月遵义医学院附属医院诊治的ARM患儿直肠末端标本30例。其中,男24例,女6例;高位ARM15例,中位ARM6例,低位ARM9例;手术年龄2d~13个月,平均1.4个月。一期腹会阴肛门成形8例;分期肛门成形13例,包括:腹腔镜辅助肛门成形7例,腹会阴肛门成形2例,后矢状入路肛门成形术4例,会阴肛门成形9例。肛门成形术中取直肠末端标本,运用苏木素/伊红(HE)染色计数直肠末端黏膜下及肌间神经丛数量,免疫组织化学(IHC)及实时定量聚合酶链反应(qRT-PCR)检测NGF及其受体(TrkA、P75NTR)在低位ARM和中高位ARM患儿直肠末端的表达情况。结果HE染色:低位ARM患儿直肠末端黏膜下及肌间神经丛分布密集,神经丛面积大,节细胞数量多;中高位ARM患儿神经丛分布明显稀疏,神经丛数量较低位ARM患儿明显减少(1.30±0.82 vs 5.60±1.36)个,两相比较,差异有统计学意义(P〈0.01)。IHC:NGF、TrkA、P75NTR主要在直肠末端黏膜下及肌间神经丛表达,NGF主要定位于胞核,TrkA主要定位于胞核及胞质,P75NTR主要定位于胞核、胞膜。NGF、TrkA、P75NTR在低位ARM患儿直肠黏膜下、肌间神经丛大量表达,其积分光密度(I0D值)分别为43.48±7.11、18.83±3.65和23.39±3.64;NGF、TrkA、P75NTR在中高位ARM患儿直肠末端表达明显减少,其积分光密度(IOD值)分别为3.70±1.21、8.49±2.68和7.17±2.28,两相比较,差异均有统计学意义(P<0.01)。qRT-PCR:NGF、TrkA、P75NTRmRNA在低位ARM患儿直肠末端的相对表达量分别为(172.22±104.38、148.78±72.45和122.83±35.45);明显高于中高位ARM患儿(80.38±43.10、73.95±47.43�Objective To explore the roles of nerve growth factor (NGF) and nerve growth factor receptor (NGFR) (TrkA, P75NTR) in enteric nervous system of distal rectum of children with anorectal malformations (ARM). Methods Specimens were obtained from 30 (24 males, 6 females) childrer;s distal rectum with ARM at our hospital during January 2011 to January 2013; According to the position of malformations,there were high (n = 15), intermediate (n = 6) and low (n = 9). Their average age was 1.4 months (range, 2 days to 13 months). One-stage abdominal-perineal anoplasty were performed in 8 cases. Among 13 cases of anoplasty by stages, the procedures included laparoscopic-assisted anorectal pull-through (LAARP) (n = 7), abdominal-perineal anoplasty (n = 2), posterior sagittal anorectoplasty (n = 4) and one-stage anpoerineal plasty (n = 9). Distal rectum was collected during operation. The hematoxylin-eosin (HE) staining was used to count the number of submucosal plexus and myenteric plexus of distal rectum. And immunohistochemistry (IHC) and quantitative real-time polymerase chain reaction (qRT-PCR) were employed to detect the expressions of NGF and NGFR in distal rectum of patients with ARM. And the expression level of low ARM was compared with that of intermediate or high ARM. Results HE staining., for patients with low ARM, distal rectum submucous and myenteric plexuses were dense with a large plexus area and a large number of intestinal ganglion cell while the distribution of nerve plexus of patients with intermediate or high ARM were obviously few and scattered. Comparing with low ARM, the number of nerve plexus obviously decreased (1.30 ± 0.82 vs. 5.60 ± 1.36, P〈0. 01) ; IHC: NGF, TrkA and p75NTR were predominantly distributed in distal rectum submucous and myenteric plexuses, NGF & TrkA in nucleus and cytoplasm and P75NTR in nucleus and cell membrane; NGF, TrkA and P75NTR had abundant expression in patients with low ARM in distal rectum subm

关 键 词:消化系统畸形 直肠 肛门 神经生长因子 肠神经系统 

分 类 号:R726.5[医药卫生—儿科]

 

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