【摘要】： Oddi括約肌(sphincter of oddi,SO)是控制膽汁排出膽道的唯一門戶,對(duì)膽囊充盈,膽汁排出及膽道系統(tǒng)正常壓力的維持等具有重要作用。Oddi括約肌功能障礙(sphincter of oddi dysfunction,SOD)是臨床上的常見病和多發(fā)病。因此,闡明SO運(yùn)動(dòng)調(diào)控機(jī)制,對(duì)于臨床理解膽道系統(tǒng)疾病的病理生理和相關(guān)疾病的治療具有重要意義。 近年研究表明胃腸道自主節(jié)律性運(yùn)動(dòng)起搏細(xì)胞——Cajal細(xì)胞(interstitial cells of Cajal,ICC)或Cajal樣細(xì)胞(interstitial Cajal-like cells)不僅存在于胃腸道內(nèi),而且亦存在于消化道以外具有自主節(jié)律性運(yùn)動(dòng)功能的器官。生理狀態(tài)下,SO具有一定的自主節(jié)律性運(yùn)動(dòng)的特性,但SO內(nèi)是否存在ICC尚未見文獻(xiàn)報(bào)道。 腸神經(jīng)系統(tǒng)(enteric nervous system,ENS)對(duì)SO具有重要的調(diào)節(jié)作用。其中,膽堿能和腎上腺素能神經(jīng)對(duì)SO功能調(diào)控的研究較多,但ENS的主要組成成分之一的非腎上腺素、非膽堿能(nonadrenergic-noncholinergic,NANC)神經(jīng)對(duì)SO的作用研究相對(duì)較少。已經(jīng)明確NANC神經(jīng)遞質(zhì)之一的一氧化氮(nitric oxide,NO)對(duì)胃腸平滑肌具有較強(qiáng)的抑制作用,據(jù)報(bào)道這種作用可能是ICC介導(dǎo)的。生理實(shí)驗(yàn)研究發(fā)現(xiàn),NO對(duì)人和豬SO的運(yùn)動(dòng)具有抑制作用,這種抑制作用是否通過ICC介導(dǎo)尚不清楚。而且,膽囊收縮素(cholecystokinin,CCK)對(duì)SO的作用是否與NO或ICC有關(guān),是值得深入探討的問題。 因此,本研究采用豚鼠SO石蠟切片的HE染色,冰凍切片的ICC特異性標(biāo)志物c-Kit蛋白和CCK的特異性抗體的免疫細(xì)胞化學(xué)染色及NADPH-d組織化學(xué)染色顯示NO神經(jīng)等方法,從形態(tài)學(xué)角度對(duì)豚鼠SO的可能調(diào)控因素進(jìn)行較詳細(xì)的觀察,期望為闡明SO的運(yùn)動(dòng)調(diào)控機(jī)制提供新的形態(tài)學(xué)依據(jù)。 主要結(jié)果如下: 一、豚鼠與大鼠SO的組織結(jié)構(gòu)比較 HE染色可見:豚鼠SO僅由膽管末端發(fā)達(dá)的平滑肌構(gòu)成,未見胰管、共同通道及開口。縱切面可見豚鼠SO分為二個(gè)壁:外側(cè)壁和十二指腸內(nèi)壁,前者在結(jié)構(gòu)上類似腸壁,由內(nèi)環(huán)和外縱兩層平滑肌組成,后者由內(nèi)外兩層縱行和中間環(huán)行平滑肌組成,切片上較容易區(qū)分。與豚鼠相比,大鼠膽管末端無SO裝置,所以,本研究主要以豚
[Abstract]:Oddi sphincter (sphincter of oddi so is the only portal to control bile excretion. It plays an important role in gallbladder filling, bile excretion and the maintenance of normal pressure of biliary system. (sphincter of oddi dysfunctional sod is a common disease and frequent disease in clinic. Therefore, it is important for clinical understanding of pathophysiology of biliary tract diseases and treatment of related diseases to elucidate the mechanism of so movement regulation. In recent years, it has been shown that Cajal cell (interstitial cells of Cajala-like cells (interstitial Cajal-like cells) exist not only in the gastrointestinal tract, but also in organs with autonomic rhythmic motor function outside the digestive tract. Under physiological conditions, so has some characteristics of autonomous rhythmic movement, but the existence of ICC in so has not been reported in literature. (enteric nervous system plays an important role in the regulation of so. Among them, cholinergic and adrenergic nerves have more studies on the regulation of so function, but the effect of nonadreneric-noncholinergic nerve on so is relatively few, one of the main components of ENS. It has been identified that nitric oxide (no), one of the neurotransmitters of NANC, has a strong inhibitory effect on gastrointestinal smooth muscle, which may be mediated by ICC. Physiological experiments showed that no inhibited the movement of so in both human and pig, and whether the inhibition was mediated by ICC is not clear. Furthermore, whether the effect of cholecystokinin (CCK) on so is related to no or ICC is a question worthy of further discussion. Therefore, HE staining of so paraffin sections of guinea pigs, immunocytochemical staining of ICC specific marker c-Kit protein and specific antibody to CCK and NADPH-d histochemical staining were used to display no nerves in frozen sections. The possible regulatory factors of so in guinea pigs were observed in detail from the point of view of morphology in order to provide a new morphological basis for elucidating the mechanism of so movement regulation. The main results are as follows: 1. Compared with the tissue structure of rat so in guinea pig, HE staining showed that the so was only composed of smooth muscle at the end of bile duct, but no pancreatic duct, common channel and opening were found. On the longitudinal section of guinea pig, so is divided into two walls: lateral wall and duodenal wall. The former is similar to the intestinal wall in structure and consists of the inner ring and the outer longitudinal smooth muscle, the latter is composed of the inner and outer longitudinal and intermediate circular smooth muscle. It is easy to distinguish on slices. Compared with guinea pigs, there was no so _ 2 device at the end of the bile duct in rats.
【學(xué)位授予單位】：第三軍醫(yī)大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2006
【分類號(hào)】：R322

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