老年反流性食管炎患者食管黏膜肥大细胞数量和功能的改变

目的 探讨老年反流性食管炎(reflux esophagitis,RE)患者食管黏膜肥大细胞的改变.方法 选择RE患者老年组28例和非老年组1 5例,采用免疫组化法,染色并计数肥大细胞和脱颗粒肥大细胞占肥大细胞总数的比率;电镜观察肥大细胞超微结构.结果 老年组的食管黏膜肥大细胞数(10.24±2.56)个,显著高于非老年组的(5.07±0.18)个,差异有统计学意义(P＜0.01);黏膜脱颗粒肥大细胞比率为(24.7±4.6)%,显著高于非老年组(13.5±5.5)%(P＜0.01);且食管黏膜中肥大细胞的细胞数随食管炎程度加重而增多(P＜0.01).电镜观察老年组食管黏膜肥大细胞内高尔基体、线粒体及内质网较多,胞质内有特异性分泌颗粒,胞质内存在较多脱颗粒后留下的空泡.结论 老年RE患者食管黏膜肥大细胞数增多,功能活跃,且与食管炎分级密切相关,可能在老年人RE的发病机制中具有一定作用.

Quantity and functional alterations of lower esophageal mucosal mast cells in elderly patients with reflux esophagitis

Objective To investigate the alteration of mast cell(MC)in elderly patients with reflux esophagitis(RE). Methods Twenty eight elderly and 15 non-elderly patients with RE were recruited.Lower esophageal mucosal mast cells and the percentage of degranulated mast cells were countered after immunohistochemieal staining.The ultrastrueture of mast cells was observed by eleetromieroscope. Results The number of mast cells in lower esophageal mucosa in elderly patients with RE was significantly more than that in non-elderly patients with RE(10.24±2.56 VS.5.07±0.18,P＜0.01),and the percentage of degranulated mast cells in lower esophageal mucosa was also significantly higher in elderly patients with RE than in non-elderly patients with RE[(24.7±4.6)%vs.(13.5±5.5)%,P＜0.01].The more severe the esophageal mucosallesions,the more the numberof mast cells. Under the electromicroscopy, more Golgi apparatus, mitochondria and endoplasm-reticulum were found in mast cells.Special secreting particles were also found in cytoplasm,more vacuole were left behind after mast cells degranulation in elderly patients with RE.Conclusions Increased numbers of mast cells and mast cell activation may be involved in the pathogenesis of elderly RE.