A型肉毒毒素对犬下食管括约肌的作用  

Effect of botulinum toxin-A on lower esophageal sphincter in dogs

作　　者：王斌[1] 张忠兵[1] 顾晓红[2] 陆月良[3] 

机构地区：[1]第二军医大学长征医院消化内科,上海200003 [2]上海市杨浦区中心医院消化内科,上海200093 [3]第二军医大学基础医学部细胞生物学教研室,上海200433

出　　处：《第二军医大学学报》2003年第12期1325-1327,共3页Academic Journal of Second Military Medical University

基　　金：上海市科学技术发展基金(994119052)

摘　　要：目的:研究A型肉毒毒素(BTA)对犬下食管括约肌(LES)的作用机制,为临床BTA治疗贲门失弛缓症提供实验依据。方法:在胃镜下对BTA组(10条犬)LES分4点注射BTA,对照组(10条犬)注射生理盐水,分别于注射前、注射后1周测定LES的压力,同时测定LES中Ach的含量和AchE活性,并观察AchE阳性神经末梢和Ach囊泡的超微结构。结果:注射BTA后1周BTA组LES压力、Ach含量和AchE活性均显著低于对照组(P<0.01);在光镜下发现,运动终板色泽变淡,数目减少;在电镜下发现,神经末梢内含Ach的囊泡明显减少,末梢内AchE阳性反应物也明显减少。结论:犬LES局部注射BTA后,可引起LES压力明显下降,这可能是由于BTA破坏或抑制局部胆碱能神经末梢运动终极中的囊泡,导致局部Ach含量和AchE活性明显降低而引起。[ABSTRACT] Objective: To investigate the effect of botulinum toxin-A (BTA) on lower esophageal sphinctor (LES) in dogs,providing scientific base for treating achalasia with BTA. Methods:BTA was endoscopically injected into the LES in 10 dogs,and saline injection was taken as control group(10 dogs). LES pressure was measured before and after injection. Contents of Ach and activity of AchE were determined in LES samples. By means of Karnovsky-Roots technique,ultrastructure of nerve terminal and vesicles containing Ach were studied under light and transmission electronic microscopy. Results:LES pressure obviously decreased in BTA-treated dogs after injection (P<0. 01). Contents of LES Ach and AchE activity in BTA-treated dogs remarkably decreased compared with those of control group (P<0. 01). The colour of motor end plate fainted away and their number decreased; the vesicles containing Ach and AchE-positive reactant were reduced distinctly in the nerve terminal. Conclusion:BTA significantly decreases LES pressure,possibly by distroying or inhibiting the vesicles of the cholin-ergic nerve terminal,leading to the decrease of Ach and AchE activity.

关 键 词：A型肉毒毒素 犬 下食管括约肌 实验 贲门失弛缓症 

分 类 号：R573.7[医药卫生—消化系统] R-33[医药卫生—内科学]