人食管上皮酸反流损伤的早期超微结构改变  

An early ultrastructural change of acid reflux-damaged human esophageal epithelium

作　　者：谷仲平[1] 刘锟[1] 王云杰[1] 罗金燕[2] 程庆书[1] 张军[2] 

机构地区：[1]中国人民解放军第四军医大学唐都医院胸外科,陕西省西安市710038 [2]西安医科大学附属第二医院消化内科,陕西省西安市710054

出　　处：《世界华人消化杂志》2000年第3期256-258,共3页World Chinese Journal of Digestology

摘　　要：目的 细胞间隙增大是兔食管上皮酸反流损伤的一个特征,它是一种只有在透射电子显微镜下才能很好观察到的早期形态学改变。本研究的目的是确定此种改变是否也是人食管酸反流损伤的一种早期表现。 方法 用透射电镜检查10例正常对照组,12例胃食管反流病(GERD)患者(经24h pH监测和压力测定诊断为GERD)的内镜活检标本(标本均取自食管下端5cm内、内镜下无异常的粘膜),用图象分析仪测量每例标本透射电镜照片的细胞间隙。 结果 胃食管反流病患者组的细胞间隙(1.27±0.77)μm大于正常对照组细胞间隙(0.49±0.08)μm,P<0.01,前者有9例有细胞间隙≥2.5μm,而正常对照组无一例有细胞间隙≥2.5μm。 结论 细胞间隙增大是人食管酸反流损伤的一种早期表现。AIM Dilated intercellular spaces are a sign of epithelial damage in rabbit acid-perfused esophagus and an early morphological change that can only be well identified under transmission electron microscopy. This study is to determine if this change is also an early feature of acid damage to human esophageal epithelium. METHODS Endoscopic esophageal biopsy specimens (obtained within the lower 5 cm of esophagus from areas of macroscopically noneroded esophageal mucosa) from controls (n = 10) and patients with gastroesophageal reflux disease (n = 12) diagnosed by 24 h pH monitoring and manometery were examined under transmission electron microscopy. The intercellular space diameter of each specimen transmission electron microscopy was measured using a digital scanner. RESULTS Intercellular space diameter was significantly greater in specimens from patients with GERD (1.27 μm± 0.77 μm) than those from controls (0.49±0.08) μm (P<0.01). Space diameters of ≥2.5 μm were present in 9 of 12 patients with GERD but none in controls. CONCLUSION Intercellular space dilatation is an early lesion in the acid-damaged human esophagus.

关 键 词：胃食管反流 透射电镜 细胞间隙 超微结构 食管 

分 类 号：R571[医药卫生—消化系统]