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目的:研究一氧化氧合成酶(NOS)在儿童贲门失弛缓症肠神经系统中的分布。方法:应用还原型辅酶Ⅱ二磷酸酶组织化学及 NOS 免疫组化方法观察13例儿童贲门失弛缓症及6例对照组远端食管、贲门、胃底及幽门部 NOS 的分布情况。结果:对照组食管、贲门、胃底及幽门部肌层内含有丰富的 NOS 染色阳性神经纤维,肌间神经节细胞呈 NOS 染色阳性。患儿组贲门部肌层中缺乏 NOS 染色阳性神经纤维,肌间神经节细胞呈 NOS 染色阴性,远端食管及胃底部偶可见散在的 NOS 染色阳性神经节细胞,幽门部 NOS 的分布与对照组基本相同。结论:远端食管、贲门及胃底部缺乏 NOS 可能与功能性贲门失弛缓症发病的病理生理有关。
Objective: To study the distribution of nitric oxide synthase (NOS) in enteric nervous system of children with achalasia. Methods: The distribution of NOS in the distal esophagus, cardia, fundus and pylorus in 13 cases of children with achalasia and 6 cases of control group was observed by the method of reduced coenzyme Ⅱ diphosphatase histochemistry and NOS immunohistochemistry. Results: The NOS positive nerve fibers in the esophagus, cardia, stomach fundus and pylorus of the control group were rich in NOS positive fibers, and the positive cells were found in the myenteric ganglion cells. There was a lack of NOS positive nerve fibers in muscular layer of cardia in children. The myenteric ganglion cells were negative for NOS staining. NOS-positive ganglion cells scattered in the distal esophagus and gastric fundus even showed a distribution of NOS in pylorus. The group is basically the same. Conclusion: The lack of NOS in the distal esophagus, cardia and fundus might be related to the pathophysiology of functional cardia achalasia.