全露型包皮中触觉小体观察
作者：谭明波，姜海洋，王固新，栾华，徐胜美，郭东。
Observation of Meissners corpuscle in entirerevealing prepuce。
ABSTRACT: Objective To observe the features of distribution of Meissners corpuscles in entirerevealing prepuce. Methods The Meissner‘s corpuscles in ridged bands and smooth mucosa of 9 samples of entirerevealing prepuce were respectively detected with immunohistochemical stain. The total number of Meissners corpuscles in both ridged band and smooth mucosa of each specimen and that of the visual fields were obtained under an optical microscope at highpowerfield of 10×10 with the results checked by using Chisquare test. Results The densities of Meissner‘s corpuscles in both ridged band and smooth mucosa of entirerevealing prepuce were 3.28% and 13.33% respectively and the difference showed statistical significance (P0.05). Density of Meissners corpuscles in ridged band of entirerevealing prepuce was significantly lower and that in smooth mucosa was significantly higher compared with the samples of abundant prepuces from matched age group(P0.05). Conclusion Density of Meissners corpuscles in smooth mucosa of entirerevealing prepuce was significantly higher than that in ridged band. The features of Meissners corpuscles distribution in inner plates of entirerevealing prepuce were significantly different from those in the abundant prepuce.
KEY WORDS: entirerevealing prepuce; Meissners corpuscle。
摘要：目的 观察全露型包皮内板组织中触觉小体分布规律。方法 收集全露型包皮标本9例，用免疫组化方法对其内板组织中的皱褶区与光整区触觉小体进行染色，在放大100倍的视野下观察和统计两处组织中触觉小体总数以及视野的总数，并进行统计学分析。结果 全露型包皮皱褶区和光整区中触觉小体的密度分别为3.28%和13.33%，差异有显著性(P0.05)。同年龄接近的一组包皮过长比较，全露型包皮皱褶区触觉小体密度明显降低，而光整区却明显增多(P0.05)。结论 全露型包皮的光整区触觉小体密度较皱褶区明显升高。全露型包皮内板中触觉小体分布规律较包皮过长具有明显的不同。
成年男子包皮解剖形态分为包茎型、包皮过长型、半露型和全露型。其中较为常见的是单纯包皮过长。全露型包皮较为少见，孟镔调查发现在18—25岁成年男性中该型包皮仅占15.2%[1]。Taylor 等研究发现人类包皮过长内板近包皮口处有一“皱褶区”，该区富含司职精细感觉的触觉小体(Meissners corpuscle)。它在男子性功能中可能扮演重要角色，在接近冠状沟处有一光整区，其中的触觉小体的密度较皱褶区明显降低[2]。全露型包皮与包皮过长大体形态明显不同，其神经末梢的分布是否也存在差异？近年来，我们收集了9例全露型包皮标本对其中触觉小体分布情况进行了观察研究。
1 材料与方法。
1.1 一般资料 包皮标本根据其解剖形态分为两组。全露型包皮组9例，均因尖锐湿疣而行包皮环切手术；年龄24—58岁，平均(29.9±6.2)岁；包皮内、外板呈皱缩状态而使龟头暴露状态。包皮过长组19例，年龄25—43岁，平均(31.5±7.2)岁。所有包皮供者均无勃起及射精功能障碍，适当地向上展平包皮时，可明确观察到包皮内板皱褶区与光整区的纹理明显不同。
1.2 标本取材 参考Taylor 等报道[2]，包皮背部正中内板皱褶区和近冠状沟光整区全厚组织。所有包皮标本用10g/L甲醛固定，石蜡包埋，组织切片厚度为2μm。
1.3 主要试剂 免疫组化染色试剂购自福州迈新生物试剂公司。一抗为即用型抗S100单克隆抗体。二步法试剂盒包含：内源性过氧化酶阻断剂、动物非免疫血清、HRP多聚螯合物抗鼠IgG。显色剂为DAB。
1.4 免疫组化染色方法 采用两步法染色观察包皮中触觉小体[3]。切片二甲苯脱蜡，梯度酒精脱水至水化。抗原修复在0.01mol/L柠檬酸缓冲液中微波处理；一抗加入标本后放入湿盒，室温下孵育1h，DAB显色，苏木素复染。