汤绍涛 刘春萍 阮庆兰 郭筱兰 430022 武汉，同济医科大学附属协和医院 中华小儿外科杂志 1999 0 20 1


    关键词：先天性巨结肠症；肠粘膜免疫功能；小肠结肠炎；急性 期刊 zhxrwkzz 0 肛肠外科 fur -->


    

【摘要】 目的 探讨HD并发小肠结肠炎的发病原因和发病机理。方法 利用放射免疫技术及免疫组织化学方法(SABC)检测HD患儿肠粘膜免疫功能。结果 13例HD患儿中，5例伴有小肠结肠炎患儿与8例无小肠结肠炎患儿相比肠腔内SIgA浓度明显降低，肠粘膜淋巴细胞转化能力减弱，固有层中含IgA的浆细胞明显增多，CD4+、CD8+细胞分布异常。结论 HD伴有小肠结肠炎患儿肠粘膜免疫功能受到抑制，多聚IgA不能通过上皮细胞转运到肠粘膜表面形成SIgA，若远端肠管狭窄，粪便淤积，细菌和病毒可侵入肠粘膜大量繁殖，引起肠道炎症，进一步导致粘膜的破坏，粘膜免疫功能更加下降，形成恶性循环，这正是HD患儿并发小肠结肠炎复杂机理所在。

    Mucosal Immune Defence in EnterocolitisComplicating with Hirschsprung's Disease

TANG Shaotao, LIU Chunping, RAN Qinglan, et al.

    Dept. of Pediatric Surgery. Union Hospital, Tongji Medical University, Wuhan 430022

【Abstract】 Objective Toinvestigate the aetiology and the pathogenesis of enterocolitis complicated withHirschsprung's disease.Methods Mucosal immune defence of colonicspecimens from patients of Hirschsprung's disease was studied by immunohistochemical andradioimmunological methods.Results Compared to the 8 patients ofHirschsprung's disease without enterocolitis, five cases with Hirschsprung's disease andenterocolitis had markedly deficient transfer of IgA across distribution of CD4 and CD8positive cells in lamina propria.Conclusions Patients of Hirschsprung'sdisease complicated with enterocolitis have compromised local mucosal immune defence.Stasis of fecal content,multiplication of bacteria and endotoxin production further damagethe mucosa, leading to deterioration of mucosal immune mechanism. This may be a possiblecomplex mechanism of Hirschsprung's disease and enterocolitis.

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