胃食管返流病食管上皮早期超微结构改变  

Early ultrastructural change in esophageal epihelium cells in gastroesophageal reflux disease

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

机构地区：[1]第四军医大学唐都医院胸外科,陕西西安710038 [2]西安医科大学附属二院消化内科

出　　处：《第四军医大学学报》2000年第8期994-997,共4页Journal of the Fourth Military Medical University

摘　　要：目的　确定细胞间隙增大是否是人食管酸返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例胃食管返流病 (GERD)患者、10例食管癌患者和 10例食管癌行“隧道式”食管胃吻合术后患者的内镜活检标本 ,用图像分析仪测量每例标本透射电镜照片的细胞间隙 .结果　胃食管返流病患者组 (1.2 7± 0 .77)μm和食管癌患者组的细胞间隙 (1.2 2± 0 .5 5 ) μm均大于正常对照组 (0 .49± 0 .0 8) μm,“隧道式”食管胃吻合术后患者组 (0 .5 5± 0 .11μm)与正常对照组细胞间隙无明显差异 .前两组分别有 9例和 7例细胞间隙≥ 2 .5 μm,而后两组无 1例细胞间隙≥ 2 .5 μm.结论　细胞间隙增大是人食管酸返流损伤的一种早期表现 ;食管癌患者同时存在 GERD;“隧道式”AIM To determine if dilated intercellular space is an early feature of acid damage to human esophageal epitheli um. METHODS By using transmission electron microscopy (TEM), we examined endoscopic esophageal biopsy specimens from the controls ( n =10), patients with gasteroesophageal reflux disease (GERD)( n =12), patients with esophageal carcinoma ( n =10) and those after tunnel esophagogastrostomy ( n =10). The intercelluar space diameter was measured by using a digital scanner from (TEM) photomicrographs of the specimen. RESULTS The intercellular space diameter thus measured was significantly greater in specimens from the patients with GERD (1.27±0.77) μm and esophageal carcinoma(1.22±0.55) μm than those from the controls(0.49±0.08) μm. The intercellular space of the patients after tunnel esophagogastrostomy operation (0.55 a±0.11) μm was not significantly different from the controls.The space diameters of≥2.5 μm were present in 9 of 12 and 7 of 10 patients with GERD and esophageal carcinoma respectively but in none of the controls and patients after tunnel esophagogastrostomy operation. CONCLUSION Intercellular spaces dilatation is an early lesion in the acid damaged human esophagus. Esophageal carcinoma is also accompanied by GERD. Tunnel esophagogastrostomy functions satisfactorily in prevention of reflux.

关 键 词：胃食管返流病 食管上皮 细胞间隙 超微结构 

分 类 号：R571.02[医药卫生—消化系统]