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肠的内在植物神经增殖早已被识别为克隆氏病的一种表现。免疫荧光研究证明许多增生的神经纤维含有血管活性肠多肽。这些变化被认为是继发现象,或许由强烈的局部炎症所造成,而未考虑与克隆氏病的发病有重要联系。本文作者前已证明,在克隆氏病患者手术切下的回肠标本中,其外观正常的切除边缘及病变区都有植物神经的轴突坏死。这些观察提出了一个可能性,即植物神经系统的轴突损伤可先于肠损伤的其他证据,而且肠植物神经病变代表克隆氏病的一个早期病理学过程。本文报导了对8例克隆氏病和4例对照病例的透射电镜观察结果。7例过去已作回肠结肠切除的克隆氏病患者,其回肠造口部位活检均示广泛的轴突坏死,不
Intestinal autonomic proliferation has long been identified as a manifestation of Crohn’s disease. Immunofluorescence studies have shown that many proliferating nerve fibers contain vasoactive intestinal polypeptide. These changes are considered secondary phenomena, perhaps caused by a strong local inflammation, without considering the incidence of Crohn’s disease is an important link. The author of this paper has previously proved that in patients with Crohn’s disease undergone surgical resection of the ileum specimens, the appearance of normal resection margins and lesions have autonomic axonal necrosis. These observations raise the possibility that axonal damage in the autonomic nervous system precedes other evidence of intestinal damage and that enteropathic neuropathy represents an early pathological process of Crohn’s disease. This article reports the results of transmission electron microscopy on eight Crohn’s disease and four control cases. Seven patients with Crohn’s disease who had undergone ileocolic colonography in the past had extensive axonal necrosis on the ileostomy site,