肥大细胞、神经纤维在先天性肠无神经节细胞症中的相关性研究

目的探讨肥大细胞、神经纤维在先天性肠无神经节细胞症(HD)患者不同肠段中有无数量及形态变化以及在HD中的可能作用。方法选择2010年1月至2011年12月重庆医科大学附属儿童医院收治的40例HD患者肠组织标本为实验组。选择10例尸检患儿(死于非消化道疾病)直肠标本作为对照组,分别采用甲苯胺蓝化学染色法、S-100免疫组织化学染色法及复合染色法处理,显微镜观察肥大细胞及神经纤维的分布及变化情况。结果镜下肥大细胞主要集中在肠段黏膜层及黏膜下层,与神经纤维毗邻,HD患者痉挛段肥大细胞较对照组及扩张段明显增多(P<0.05),脱颗粒明显,黏膜下层S-100阳性神经纤维表达增强(P<0.05),肥大细胞密度与神经纤维的密度及面积具有相关性(r=0.573,P<0.01;r=0.514,P<0.01)。结论肥大细胞与神经纤维关系密切,两者的变化及相互作用在HD的发病机制中具有重要意义。

Relationship between mast cells and nerve fibers in colon of patients with Hischsprung's disease

Objective To investigate whether there are quantitive and morphological changes of mast cells and never fibers in different segments of the colon,and to explore their roles in the pathogenesis of Hischsprung′s disease(HD).Methods The stenotic,transitional and dilated segments in 40 patients with HD were collected as the experimental group in Children′s Hospital of Chongqing Medical University form January 2010 to December 2011.10 samples died of non-gastrointestinal disease were collected as the control group.Each specimens was stained by toluidine blue,S-100 immunohistochemistr and compounding.The distribution of mast cells and nerve fibers were observed by light microscope,and the results were evaluated by color image analyzer.Results The mast cells were localized in mucosal and submucosal,and they were notably present around the nerve fibers.In the experimental group,the number of mast cells in stenotic intestine was significantly higher than that in the dilated intestine and the control group(P<0.05).Mast cells de-granulation and S100-positive fibers were seen significantly in the stenotic intestine group(P<0.05).The number and the area of S100-positive fibers were positively correlated with the number of mast cells(r=0.573,P<0.01;r=0.514,P<0.01).Conclusion The close relations exist between mast cells and nerve fibers,their changes and interaction may play an important role in the pathogenesis of HD.