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目的探讨突触素(SY)和Cajal间质细胞(ICCs)在先天性巨结肠(HD)中的变化和临床意义。方法应用免疫组织化学方法和病理显微镜图像分析系统,计算48例HD患儿和10例正常对照儿SY和ICCs阳性染色区域面积并进行对比。结果HD患儿扩张段内SY和ICCs阳性面积与对照组比较,差异无统计学意义[(3.27±1.05)vs.(3.53±0.89);(2.09±1.28)vs.(2.22±1.31);P>0.05],而狭窄段肠壁内SY和ICCs镜下阳性面积均比对照组明显减少[(1.34±0.97)vs.(3.53±0.89);(1.41±0.85)vs.(2.22±1.31);P<0.01]。HD病变肠段肠电图出现异常波型。结论突触素和Cajal间质细胞的分布异常是HD的重要病理改变,这种改变导致了病变肠管慢波节律形成和兴奋传导的异常,引起或加重了HD的动力障碍。
Objective To investigate the changes and clinical significance of synaptophysin (SY) and Cajal interstitial cells (ICCs) in Hirschsprung’s disease. Methods Immunohistochemistry and pathological microscope image analysis system were used to calculate the area of positive staining area of SY and ICCs in 48 cases of HD children and 10 normal controls. Results There was no significant difference in the positive area of SY and ICCs between the two groups ([(3.27 ± 1.05) vs. (3.53 ± 0.89) vs. (2.09 ± 1.28) vs. (2.22 ± 1.31) P > 0.05]. The positive area of SY and ICCs in the narrow intestine was significantly lower than that of the control group [(1.34 ± 0.97) vs. (3.53 ± 0.89) vs (1.41 ± 0.85) vs. (2.22 ± 1.31), respectively P <0.01]. Hyperthyroidism in HD intestine intestinal segments. Conclusions The abnormal distribution of synaptophysin and interstitial cells of Cajal is an important pathological change of HD. This change leads to the abnormality of slow wave rhythm and excitability conduction in the intestinal tract, which causes or aggravates the motility disorder of HD.