兔直肠黏膜内脱垂模型不同造模时期超微结构的变化  

Ultrastructural changes of rabbit internal rectal mucosal prolapse model at different modeling stages

作　　者：柯敏辉[1] 黄鸿铃 延永琴 许振国[1] 郑霞霞[1] 郑鸣霄[1] Ke Minhui;Huang Hongling;Yan Yongqin;Xu Zhenguo;Zheng Xiaxia;Zheng Mingxiao(Department of Anorectum,Second Affiliated People’s Hospital of Fujian University of Traditional Chinese Medicine,Fuzhou 350003,China;Department of Pathology,Chinese People’s Liberation Army Joint Service Support Force No..900 Hospital,Fuzhou 350025,China)

机构地区：[1]福建中医药大学附属第二人民医院肛肠科,福州350003 [2]中国人民解放军联勤保障部队第九〇〇医院病理科,福州350025

出　　处：《中华实验外科杂志》2022年第3期442-446,共5页Chinese Journal of Experimental Surgery

基　　金：国家自然科学基金面上项目(81774118);福建省科技厅引导性项目(2019Y0029);福建中医药大学校管课题(X2019063-学科)。

摘　　要：目的比较直肠黏膜内脱垂兔造模过程中直肠黏膜变化的差异,探讨直肠黏膜内脱垂的形成机制。方法采用中药大黄和番泻叶液灌胃、站立与无水酒精肛周注射3种方法联合造模,用电子显微镜观察兔直肠黏膜的超微结构。结果正常组扫描电镜见直肠黏膜微绒毛排列紧密、细胞界限不清;透射电镜见基底膜均连续、完整,未见破坏,结缔组织中可见纤维细胞及散在的纤维束,细胞膜完整。造模中期组透射电镜见基底膜结构完整,下方结缔组织局灶见成纤维细胞凋亡,凋亡小体形成。造模完成组扫描电镜见直肠黏膜细胞交界处微绒毛明显凹陷;透射电镜见基底膜结构被破坏;结缔组织中均可见到毛细血管不同程度扩张、内皮细胞变性,小部分区域见大量纤维细胞凋亡,间质中可见成片细胞坏死,细胞膜被破坏、细胞器外溢,间质纤维组织疏松、排列紊乱。结论直肠黏膜内脱垂的形成与成纤维细胞改变、细胞外基质稳态破坏,致基底膜破坏、结缔组织间质改变,从而引起纤维结构变化等一系列病理改变有关。Objective To compare the differences of rectal mucosal changes in rabbits with internal rectal mucosal prolapse during modeling,so as to explore the mechanism of internal rectal mucosal prolapse.Methods The model was established by the combined method of traditional Chinese medicine Radix et Rhizoma Rhei and Folium sennae liquid gavage,standing and perianal injection of anhydrous alcohol.The ultrastructure of rectal mucosa in rabbits was observed by electron microscopy.Results In the normal group,the scanning electron microscopy showed that the microvilli of the rectal mucosa were arranged closely and the cell boundary was unclear.The transmission electron microscopy showed that the basement membranes were continuous and intact without damage.Fibrocytes and scattered fiber bundles were observed in the connective tissues,and the cell membrane was intact.In the middle modeling group,the complete basement membrane structure was observed under the transmission electron microscopy,and fibroblast apoptosis and apoptotic bodies were observed in the focal connective tissue below.In the modeling completion group,the scanning electron microscopy showed that the microvilli at the junction of the rectal mucosal cells were significantly depressed.The basement membrane structure was damaged under the transmission electron microscopy.In the connective tissues,telangiectasia to different extents and degeneration of endothelial cells could be seen,together with a large number of apoptotic fibroblasts in a small part of the area,as well as necrosis of sheets of cells in the mesenchyme,destruction of cell membrane and overflow of organelles.The interstitial fibrous tissues were loose and arranged disorderly.Conclusion The formation of rectal internal mucosal prolapse is related to a series of pathological changes,such as changes in fibroblasts and the steady state of ECM,leading to the destruction of basilar membrane and the change of connective tissue interstitium,as well as the changes of fibrous structure.

关 键 词：直肠黏膜 超微结构 电镜 

分 类 号：R657.19[医药卫生—外科学] R-332[医药卫生—临床医学]