摘要
目的 探讨血管活性肠肽 (VIP)和一氧化氮 (NOS)在Oddi括约肌功能障碍发病机制中的作用。方法 选择 68例因不明原因的上腹痛、黄疸而进行逆行胰胆管造影及乳头括约肌切开术的患者 ,采用内镜下活检 ,钳取乳头黏膜、Oddi括约肌及胆管内壁组织各 1块。标本常规石蜡包埋 ,连续切片 ,免疫组化链酶亲和素 过氧化物酶法 (SABC法 )观察乳头组织内VIP及NOS的变化。将 68例患者分为Oddi括约肌功能障碍组 (SOD组 )与非Oddi括约肌功能障碍组 (非SOD组 )。结果 SOD患者乳头黏膜及Oddi括约肌内VIP和NOS含量明显减少 (P <0 .0 5 ) ,VIP和NOS含量呈正相关关系 (r =0 .87,P <0 .0 1)。结论 乳头局部组织中VIP和NOS的表达明显降低。
Objective To investigate the role of vasoactive intestinal polypeptide (VIP) and nitric oxide synthase (NOS) in the pathogenesis of Oddi's sphincter dysfunction (OSD).Methods Endoscopic retrograde cholangiopan-creatography (ERCP) and endoscopic sphincterotomy (EST) were performed in 68 patients with upper abdomen pain,fever and jaundice.Biopsies from duodenal epithelium of the papilla of Vater and from ampullary local tissue which includes mucosa,submucosa,Oddi's sphincter and the mucosa of bile tract epithelium were taken by duodenoscopy-biopsy forceps after sphincterotomy in all patients.And then the levels of VIP and NOS in these specimens were investigated by means of immunohistochemical technique (SABC method).Results In patients with OSD the mean contents of VIP and NOS in the mucosa of the papilla and Oddi's sphincter were lower significantly than those in healthy subjects (P<0.05).There was no marked difference of VIP and NOS content in the mucosa.The contents between VIP and NOS both in mucosa layer and in sphincter layer were positively correlated(r=0.87,P<0.01).Conclusion VIP and NOS have been proposed as inhibitory neurotransmitters in the sphincteric and non sphincteric smooth muscles of the gut.Our result suggests that VIP and NOS may play an important role in pathogenesis of SOD.SOD is probably associated with the decrease of VIP and NOS in the Oddi's sphincter.
出处
《临床内科杂志》
CAS
北大核心
2004年第10期668-670,共3页
Journal of Clinical Internal Medicine
