Goto S, Ikeda K, Toyohara T
Z Kinderchir. 1984 Aug;39(4):246-9. doi: 10.1055/s-2008-1044217.
Proliferating patterns of acetylcholinesterase (AChE) positive nerve fibres were investigated in 23 neonates with Hirschsprung's disease. All subjects were separated into three groups, according to age. In group A (0-10 days old) adn groups B (11-20 days old, no increase in AChE positive nerve fibres was evidenced in the lamina propria mucosae, whereas 7 out of 9 cases in group C (21-28 days old) showed a moderate or marked increase in AChE positive nerve fibres in the lamina propria mucosae. A typical pattern of this proliferation up to the lamina propria mucosae was seen in 30.4% only of all cases in the series, and was limited to group C, where the positive AChE reaction from the submucosa to the muscularis mucosae (including the submucosa only), the rate was 91.3%. Re-examination was preformed in 14 cases over sthe neonatal period. All showed a positive AChE reaction up to the lamina propria mucosae. Suction biopsy specimen from neonates is sometimes inadequate with respect to the lack of inclusion of the muscularis mucosae and submucosa, as a result of a weakly negative pressure by suction. The normal reactions of AChE activity in the lamina propria mucosae do not exclude Hirschsprung's disease in neonates. Therefore, when a histochemical diagnosis of Hirschsprung's disease using rectal suction biopsy for staining of AChE activity is required in the neonatal period, the diagnosis is safe and relatively easy at least over three weeks of age as mentioned above.
对23例患有先天性巨结肠症的新生儿的乙酰胆碱酯酶（AChE）阳性神经纤维的增殖模式进行了研究。所有受试者根据年龄分为三组。A组（0 - 10日龄）和B组（11 - 20日龄）的固有层黏膜中未发现AChE阳性神经纤维增加，而C组（21 - 28日龄）9例中有7例固有层黏膜中AChE阳性神经纤维呈中度或显著增加。在该系列所有病例中，仅30.4%的病例出现了这种增殖至固有层黏膜的典型模式，且仅限于C组，其中从黏膜下层到黏膜肌层（仅包括黏膜下层）的AChE阳性反应率为91.3%。在新生儿期对14例进行了复查。所有病例均显示至固有层黏膜的AChE阳性反应。由于吸力负压较弱，新生儿的吸引活检标本有时因未包含黏膜肌层和黏膜下层而不充分。固有层黏膜中AChE活性的正常反应不能排除新生儿先天性巨结肠症。因此，在新生儿期需要通过直肠吸引活检对AChE活性进行染色以组织化学诊断先天性巨结肠症时，如上述，至少在三周龄以上诊断是安全且相对容易的。
