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目的 观察葡萄糖转运体 1(GLUT 1)和一氧化氮合酶 (NOS)阳性神经在Hirschsprung病 (HD)肠壁中的变化并探讨二者与HD发病的关系。方法 应用还原型辅酶Ⅱ 黄递酶组织化学和免疫组织化学染色观察 9例HD及 5例对照组患儿结肠。结果 在正常结肠的肌层和粘膜下层内偶见细小的GLUT 1免疫反应性神经纤维 ,肠壁外的外源性神经纤维呈阳性染色 ;而在无神经节细胞肠段的相应区域内GLUT 1免疫反应性神经纤维数量明显增多、增粗。在正常结肠肠壁内有大量NOS阳性神经节细胞 ,环肌层内含有丰富的阳性神经纤维 ;而在无神经节细胞肠段的肠壁内缺乏NOS阳性神经元 ,肌层内阳性神经纤维明显减少。结论 肠壁内GLUT 1阳性神经可能为外源性神经 ,GLUT 1免疫组织化学染色可能对HD具有诊断价值。NOS阳性神经在病变肠壁中的分布异常可能与HD的病理生理机制有关。
Objective To observe the changes of GLUT 1 and NOS positive neurons in the intestinal wall of Hirschsprung disease (HD) and to explore their relationship with the pathogenesis of HD. Methods The reduction of the coenzyme diaphorase histochemical and immunohistochemical staining of 9 cases of HD and 5 cases of control children colon. Results In the normal colon mucosa and submucosa occasionally small GLUT 1 immunoreactive nerve fibers, exogenous nerve fibers outside the intestinal wall were positive staining; in the absence of ganglion cells in the corresponding area GLUT 1 The number of immunoreactive nerve fibers increased significantly, thickening. NOS positive ganglion cells are abundant in the normal colonic gut wall, which is rich in positive nerve fibers in the muscular layer of the colon. In the absence of NOS positive neurons in the intestinal wall of the intestine without ganglion cells, the positive nerve fibers in the muscular layer are obvious cut back. Conclusion The GLUT 1 positive nerve in the intestinal wall may be exogenous nerve. Immunohistochemical staining of GLUT 1 may be of diagnostic value for HD. The abnormal distribution of NOS positive nerve in the intestinal wall may be related to the pathophysiology of HD.