本文關(guān)鍵詞： Hirschsprung病 間質(zhì)細(xì)胞 細(xì)胞凋亡　出處：《臨床小兒外科雜志》2016年01期 　論文類型：期刊論文

【摘要】：目的探討Cajal間質(zhì)細(xì)胞(interstitial cells of Cajal,ICCs)凋亡在先天性巨結(jié)腸癥(Hirschsprung's disease,HD)及其同源病(Hirschsprung's allied disease,HAD)結(jié)腸肌層中的表達(dá)及作用。方法 2014年2月至2015年2月我們采取腹腔鏡手術(shù)治療15例HD和13例HAD,切取HD痙攣段、移行段及擴(kuò)張段和HAD近端與遠(yuǎn)端全層腸壁作檢驗(yàn)組。另選取10例正常兒結(jié)腸標(biāo)本作對(duì)照組。應(yīng)用免疫熒光雙標(biāo)記技術(shù)檢測(cè)不同病變腸管肌層中ICCs分布密度以及caspase-3、bcl-2表達(dá)情況。應(yīng)用透射電鏡觀察不同病變腸管肌層中ICCs超微結(jié)構(gòu)改變。結(jié)果結(jié)腸肌層中ICCs分布密度(個(gè)/視野)在HD組痙攣段(5.8±1.1)、移行段(10.0±1.8)及擴(kuò)張段(13.1±2.1)和HAD組近端(16.5±2.4)與遠(yuǎn)端腸段(8.6±1.6),除HAD組近端與對(duì)照組(17.8±1.5)相比差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)外,其余各組兩兩比較均存在明顯差異(P0.05);各組中caspase-3陽(yáng)性ICCs表達(dá)率分別為(77.6±13.8)%、(53.6±10.2)%、(31.9±8.0)%、(23.6±6.8)%、(57.2±12.1)%,均明顯高于對(duì)照組的(6.3±4.3)%(P0.05);同時(shí)各組中bcl-2陽(yáng)性ICCs表達(dá)率分別為(18.3±9.3)%、(31.5±7.3)%、(42.3±7.9)%、(48.7±6.5)%、(38.5±6.7)%,與對(duì)照組的(60.3±5.4)%相比均明顯降低(P0.05)。ICCs分布密度與caspase-3表達(dá)呈負(fù)相關(guān)(r=-0.915,P0.01)、與bcl-2表達(dá)呈正相關(guān)(r=0.754,P0.01)。電鏡觀察HD組、HAD組病變腸管均發(fā)現(xiàn)ICCs凋亡樣改變。結(jié)論 HD、HAD病變結(jié)腸肌層ICCs分布密度及caspase-3、bcl-2表達(dá)異常,表明ICCs細(xì)胞凋亡可能在HD、HAD的發(fā)病中發(fā)揮重要作用。
[Abstract]:Objective to investigate the expression and role of interstitial cells of Cajal interstitial cells of ICCs in the myometrium of Hirschsprungus disease (HD) and its homologous disease, Hirschsprungus allied disease (HADD). Methods from February 2014 to February 2015, 15 patients with Hirschsprungus allied disease were treated with laparoscopic surgery. HD and 13 HADs were removed from HD spastic segment. The transitional and dilated segments and the proximal and distal intestinal walls of HAD were used as the test group. Ten normal children colon specimens were selected as the control group. The distribution density of ICCs and caspase-3 bcl-2 in the myometrium of different lesions were detected by immunofluorescence double labeling technique. The ultrastructural changes of ICCs in the myometrium of different lesions were observed by transmission electron microscope. Results the distribution density of ICCs in the myenteric layer of colon was 5.8 鹵1.1 in HD group, 10.0 鹵1.8 in transitional segment and 13.1 鹵2.1 in dilated segment in HD group and 16.5 鹵2.4 in HAD group. There was no significant difference between the proximal end of HAD group and the control group (17.8 鹵1.5), except that there was no significant difference (P 0.05) between the proximal end of the HAD group and the control group (P 0.05). The positive ICCs expression rate of caspase-3 in each group was 77.6 鹵13.80.The positive ICCs expression rate was 53.6 鹵10.2 鹵31.9 鹵8.0 in the other groups, which was significantly higher than that in the control group (60.3 鹵5.4%), and the expression rate of bcl-2 positive ICCs in each group was 18.3 鹵9.3 鹵7.3m, 42.3 鹵7.98.78.7 鹵6.55.70.The expression rate was significantly lower than that in the control group (60.3 鹵5.4% vs 60.3 鹵5.4%), and the expression rate of bcl-2 positive ICCs was significantly lower than that of the control group (60.3 鹵5.4ng%), and the expression rate of bcl-2 positive ICCs was significantly lower than that of the control group (60.3 鹵5.4% vs 60.3 鹵5.4%, respectively), and the expression rate of bcl-2 positive ICCs was 42.3 鹵7.98.78.68.5 鹵6.70.The positive ICCs expression rate in each group was significantly lower than that in the control group (60.3 鹵5.4%), and the expression rate of bcl-2 positive ICCs was significantly lower than that in the control group. The distribution density was negatively correlated with the expression of caspase-3, and was positively correlated with the expression of bcl-2. ICCs apoptosis-like changes were found in the intestinal duct of HD group. Conclusion the distribution density of ICCs and the expression of caspase-3 bcl-2 in colon myometrium of HD group were abnormal. These results suggest that ICCs cell apoptosis may play an important role in the pathogenesis of HD had.
【作者單位】： 河北醫(yī)科大學(xué)第二醫(yī)院小兒外科;
【基金】：國(guó)家衛(wèi)生和計(jì)劃生育委員會(huì)公益性行業(yè)科研專項(xiàng)(編號(hào):201402007)
【分類號(hào)】：R726.5

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