de Brito I A, Maksoud J G
J Pediatr Surg. 1987 May;22(5):425-30. doi: 10.1016/s0022-3468(87)80262-2.
The acetylcholinesterase (AChE) activity in Hirschsprung's disease was analyzed for histochemical patterns according to age. Its evolutional nature was also assessed. Two hundred thirty children (0 to 16 years of age) with acute or chronic obstipation were submitted to rectal suction biopsy for AChE histochemical staining. One hundred nineteen of them showed abnormal AChE activity. Retrospective analysis of those cases permitted us to establish three histochemical patterns: Pattern I, thick nerve trunks present only in the submucosa and, characteristically, absence of AChE activity in the lamina propria. This pattern was predominant in newborn up to 3 months of age and was designated the newborn pattern. Pattern II, thin nerve fibers in the muscularis mucosae and submucosa with a clear infiltration in the lamina propria. This pattern was mainly seen in children older than 1 year of age and was called classical pattern. Pattern III, an intermediate pattern showing morphologic characteristics of the two previous patterns with predominance of one or another, according to the age. A prospective study was also made in 15 children with Hirschsprung's disease who were submitted to suction rectal biopsies at different ages. In this study, a clear evolutional character of the AChE activity was observed from the newborn pattern to the intermediate and finally to the classical pattern.
根据年龄对先天性巨结肠症中的乙酰胆碱酯酶（AChE）活性进行了组织化学模式分析。还评估了其演变性质。230名（0至16岁）患有急性或慢性便秘的儿童接受了直肠吸引活检以进行AChE组织化学染色。其中119名显示AChE活性异常。对这些病例的回顾性分析使我们能够确定三种组织化学模式：模式I，粗大神经干仅存在于黏膜下层，其特征是固有层中无AChE活性。这种模式在出生至3个月大的新生儿中占主导地位，被称为新生儿模式。模式II，黏膜肌层和黏膜下层有细神经纤维，固有层有明显浸润。这种模式主要见于1岁以上儿童，被称为经典模式。模式III，一种中间模式，根据年龄显示出前两种模式的形态特征，以其中一种为主。还对15名先天性巨结肠症儿童进行了前瞻性研究，这些儿童在不同年龄接受了直肠吸引活检。在这项研究中，观察到AChE活性从新生儿模式到中间模式再到经典模式有明显的演变特征。
