Yoshida M M, Schuffler M D, Sumi S M
Department of Medicine, University of Washington School of Medicine, Seattle.
Gastroenterology. 1988 Apr;94(4):907-14. doi: 10.1016/0016-5085(88)90546-x.
Because there is evidence for vagal autonomic neuropathy as the cause of diabetic gastroparesis, we hypothesized that this disorder should be associated with morphologic abnormalities of the abdominal vagus nerve or gastric myenteric plexus, or both. We studied the smooth muscle and myenteric plexus of the stomach in 18 nondiabetic controls and 16 patients with long-standing diabetes. Five of the diabetics had gastroparesis and 11 did not. We utilized conventional histology and Smith's silver technique for visualizing the myenteric plexus. Neurons within the myenteric plexus were quantified in sections stained with each technique. The abdominal vagus nerves from 5 diabetics (2 with gastroparesis) and 12 nondiabetic controls were stained with hematoxylin and eosin, Gomori trichrome, luxol-fast blue, and Holmes' silver stains. There were no abnormalities in the numbers or appearance of neurons or axons in the myenteric plexus of the stomach of diabetics, with or without gastroparesis. Also absent were abnormalities of the smooth muscle or vagus nerve. Thus, no morphologic abnormalities of the gastric wall or abdominal vagus were identified in diabetic gastroparesis.
由于有证据表明迷走神经自主神经病变是糖尿病性胃轻瘫的病因，我们推测这种疾病应与腹部迷走神经或胃肌间神经丛或两者的形态学异常有关。我们研究了18名非糖尿病对照者和16名长期糖尿病患者的胃平滑肌和肌间神经丛。其中5名糖尿病患者患有胃轻瘫，11名没有。我们采用传统组织学和史密斯银染技术观察肌间神经丛。用每种技术染色的切片中对肌间神经丛内的神经元进行定量。对5名糖尿病患者（2名患有胃轻瘫）和12名非糖尿病对照者的腹部迷走神经进行苏木精-伊红染色、Gomori三色染色、卢克斯奥尔快速蓝染色和霍姆斯银染色。无论有无胃轻瘫，糖尿病患者胃肌间神经丛中神经元或轴突的数量及外观均无异常。平滑肌或迷走神经也无异常。因此，在糖尿病性胃轻瘫中未发现胃壁或腹部迷走神经的形态学异常。
