先天性肛门直肠畸形直肠末端PGP9.5和S-100蛋白表达的临床研究
- 关键词:
- 肛门/畸形; 直肠/畸形; 神经系统蛋白质S-100蛋白
- 摘要:
- 目的研究先天性肛门直肠畸形末端肠壁内神经系统发育情况,探讨术后排便功能障碍的病理机制。方法收集2001年1月至2005年12月先天性肛门直肠畸形结肠盲端标本76例(包括高位11例,中位26例,低位39例)。记录平均胎龄、出生体重及取得直肠标本时的年龄。采用免疫组织化学方法检测PGP9.5和S-100蛋白在上述标本中的表达水平。结果不同类型先天性肛门直肠畸形患儿出生时胎龄和平均体重比较无统计学意义。PGP9.5和S-100在高位畸形患儿中的表达明显低于中位畸形(高位vs中位,PGP9.5:0.422±0.008vs0.447±0.006,P值=0.0226;S-100:0.417±0.009vs0.442±0.007,P值=0.0401)和低位畸形(高位vs低位,PGP9.5:0.422±0.008vs0.450±0.009,P值=0.0331;S-100:0.417±0.009vs0.447±0.010,P值=0.0436);中位和低位畸形比较,差异无统计学意义(P>0.05);中位畸形一期手术组直肠末端PGP9.5和S-100的表达明显低于分期手术组(PGP9.5:0.421±0.010vs0.453±0.006,P值=0.0128;S-100:0.413±0.010vs0.449±0.006,P值=0.0048);低位畸形26例男性患儿取得直肠盲端标本时的平均年龄为(0.11±0.08)个月,13例女性患儿平均年龄为(6.15±0.29)个月(P<0.0001),但直肠末端PGP9.5和S-100的表达差异无统计学意义(P>0.05)。结论先天性肛门直肠畸形末端肠壁内神经系统的发育程度与畸形位置密切相关,这可能是高位畸形术后排便障碍的发生机制之一,中位畸形盲端肠壁内神经系统的发育可随年龄逐渐趋向于成熟。
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