多器官功能障碍综合征时胃肠Cajal间质细胞形态学的变化

目的探讨多器官功能障碍衰竭综合征(MODS)大鼠胃肠Cajal间质细胞(interstitial cells of cajal,ICC)形态学变化及MODS胃肠慢波活性减弱机制。方法Wistar大鼠17只,分为正常组和MODS组。对各组取胃体、胃窦、小肠标本,用免疫荧光染色法观察ICC在胃肠道的分布,并用电镜观察ICC的超微结构变化。结果与正常组比较,MODS组胃肠肌间神经丛ICC的荧光染色呈间断分布,条带样完整结构消失,细胞间出现较大间隔,细胞突起不明显,细胞数量很少。电镜下见MODS组ICC细胞核皱缩,异染色质趋边,胞膜泡状化,线粒体数量减少,次级溶酶体增多,与邻近平滑肌细胞、神经末梢和其他ICC之间的连接减少或消失。结论MODS可引起胃肠起搏区域ICC数量减少和超微结构改变,直接影响细胞间信号传导,使慢波活性下降,引起胃肠运动功能障碍。

Morphological changes of Cajal interstitial cells of gastrointestine in multiple organ dysfunction syndrome

Objective To investigate the morphological changes of interstitial cells of cajal (ICC) in rat gastrointestinal tract in multiple organ dysfunction syndrome (MODS),and to explore the mechanism of decreased gastrointestinal slow wave activity.Method Wistar rats were randomly divided into control group and MODS group.The gastrointestinal specimens,tissue of gastric antrum and small intestine were collected.The distribution and the number of ICC in gastrointestinal tract were detected by using immunofluorescence stain,and the ultrastructural changes of ICC was observed by using the transmission electron microscopy.Results Compared with the control group,the fluorescence staining of ICC in myenteric plexus (IC-MY) of gastrointestinal tract were discontinuously distributed,the band-liked structure disappeared,the gap between ICC was widened,the processes were unclear,and the number of IC-MY was reduced in MODS group.The nuclei of IC-MY were shrunken,and heterochromatin tended to the edge,plasma membrane bleb was displayed,the number of mitochondrion was decreased and the secondary lysosome increased,the gap-junction between ICC and neighbor smooth muscle cells,terminal nerve,and the other ICC was decreased or disappeared.Conclusions The number of ICC in gastrointestinal pacemaker region was reduced in MODS,and the ultrastructure of ICC was damaged markedly.ICC led to a direct impact on signal conduction between cells,decreased the slow wave activity,and resulted in the gastrointestinal motility disorder.