慢性萎缩性胃炎脾虚证的病理组织学与超微结构观察

通过对慢性萎缩性胃炎脾虚证胃粘膜活检标本300例的组织学、26例扫描电镜及34例透射电镜的观察,发现本病证型间的基本病变无本质上的不同,但有程度上的差异。脾胃气(阳)虚证多属轻症,脾胃阴虚证多属重症。胃粘膜各类细胞线粒体的退行性病变,是脾虚证发生的病理基础。由于线粒体的退变程度及损伤数量的不同,引起胃粘膜萎缩程度上的差异,是证型区分的基础,也是病情由气虚向阳虚而阴虚发展演变规律的依据。脾胃阴虚患者胃粘膜突出的炎症变化,是与气(阳)虚证的主要区别,也是该证的病理特征。

Observations on Histopathology of Spleen Deficiency Syndrome of Chronic Atrophic Gastritis and Its Ultrastructural Changes

Pathologic change of gastric mucosa in 247 CAG patients of Spleen Qi (Yang) Deficiency (QYD)and Spleen-Stomach Yin Deficiency (YD) Syndrome were observed. The surface of gastric antrummucosa of 26 patients with scanning electron microscope as well as the gastric mucosa of 34 patients with transmission electron microscope was observed for their intracellular structure. It was foundthat the CSAG and CAGI of Spleen QYD amounted to 165 cases (66.8%), and CAG II and III ofSpleen-Stomach YD amounted to 34 cases (64.2%). It denoted that the Spleen QYD belonged to mildcase, while the Spleen-Stomach YD belonged to severe case. The mitochondria of all kinds of gastricantrum mucosa cells showed retrograded degeneration, the pathologic basis of Spleen Deficiency ofCAG, those of Spleen-Stomach QD had sparse broken and swollen mitochondria (82.3%), while the53.3% of Spleen-Stomach YD displayed vacuolation as its predominant change. The differentseverity of retrograde degeneration and damage of mitochondria yielded various stage in atrophy ofgastric mucosa which was the basis of Syndromes evolution from Defi. to QYD and then YD.Inflammatory change of the gastric mucosa was predominant in Spleen-Stomach YD (45.3%), andfar less in QYD (27.1%), P<0.01.