摘要
采用常规胃镜下十二指肠降部粘膜活检，对降部粘膜绒毛组织学及微绒毛超微结构进行观察并行相应图像定量分析。营养性贫血组２１例，包括９例巨幼细胞贫血，１２例缺铁性贫血，其中６例行电镜观察。对照组２６例，其中１１例行电镜观察。结果，营养性贫血组绒毛长度显著缩短（Ｐ＜０．０１），绒毛宽度显著增宽（Ｐ＜０．０１），隐窝深度明显加深（Ｐ＜０．０１），本组多有不同程度的萎缩，中、重度萎缩占１４／２１（χ￣２＝６．０１，Ｐ＜０．０５）。组织学观察还可见不同程度的绒毛融合、扭曲和消失，核增大，粘膜下炎性细胞浸润。其中７例贫血纠正后复查十二指肠降部，粘膜活检表明粘膜萎缩和炎症程度明显减轻（Ｐ＜０．０１）。超微结构及图像定量观察表明微绒毛密度稀疏（Ｐ＜０．０１）、高度减低（Ｐ＜０．０１），表面积缩小（Ｐ＜０．０１），其它可见微绒毛长短不一、排列不齐、融合及萎缩、核变大。结果揭示了从绒毛到微绒毛的一系列改变，表明营养性贫血可以引起吸收不良的病理改变，纠正贫血后这种改变是可以恢复的。
iopsies of descending dudenum were taken throughroutine gastroendoscope. An observation on the patho-logical changes of mucosal villi and ultrastructuralchanges of microvilli as well as a quantitative imageanalysis were carried out correspondingly. Total 21 sam-ples from nutritional anemia patients( 9 with mega-loblastic anemia and 12 with iron deficiency anemia )were examined under microscope and 6 of them underelectromicroscope.26 control samples were examinedunder microscope and 11 of them under electromi-croscope. Significant shortening (P<0.01)and widen-ing(P<0. 01)of villi, deepening of crypts(P<0.01)and varying degrees of duodenal villus atrophy were pre-sent in the nutritional anemia group. Moderate to severeatrophy was observed in 67%of the patients(χ￣2=6.01,P<0.05).Other pathological changes such as fusion,twist and disappearance of mucosal villi,enlarged nuclei,and submucosal inflammatory reaction were also ob-served. After correction of the anemia , biopsy specimenswere again obtained in 7 of the patients and showed defi-nite improvernents.Quantitative image analysis underelectromicroscope showed significant decrease in the den-sity, height and surface area of microvilli(P<0.01).Avariety of ultrastructural changes such as deformation,atrophy and fusion of microvilli were also observed.Ourresults suggested that nutritional anemia could causemalabsorptive changes which were irnproved after cor-rection of the anemia.
出处
《中华血液学杂志》
CAS
CSCD
北大核心
1994年第6期293-297,共5页
Chinese Journal of Hematology
关键词
大细胞性贫血
肠粘膜
组织学
贫血
Nutritional anemia Intestinal mucosa Pathology Ultrastructure
