肥大细胞脱颗粒在幽门螺杆菌致病中的作用

目的 研究肥大细胞（MC）在幽门螺杆菌（H pylori)发病中的作用。方法 选胃镜检查者87例，其中诊断十二指肠溃疡（DU）33例，浅表性胃炎45例，糜烂性胃炎9例。取胃窦、体部活检分别作组织病理学（HE染色）及H pylori检查（快速尿素酶、培养及Warthin-Starry银染），免疫组织化学染色（ABC法）后分别计算粘膜及粘膜下的完整和脱颗粒MC数。结果 MC计数在H pylori阳性和H pylori阴性组间无明显差别（P＞0．05），但前者粘膜内MC脱颗粒者明显多于后者（分别为43％和23％，P＜0．01）。MC计数与粘膜炎症程度无明显关系，但在活动性炎症时显著高于非活动性炎症组（P＜0．05）。各病变组间MC计数也无显著差异。结论 MC可能在粘膜H pylori相关炎症的发生发展中起着重要作用。

Effect of mast cell degranulation in the pathogenesis of helicob acter pylori associated mucosal inflammation

Aim To investigate the effect of gastric mast cell and its degranulation in the pathogenesis of H.pylori associated mucosal inflammation.Methods An avidin biotin complex immunohistochemical procedure was used to determine mast cell character and its distribution in formaldehyde fixed gastric mucosa from the patients with duodenal ulcer ( n =33),superficial gastritis ( n =45) and erosive gastritis( n =9).The mucosa was also examined for histopathology by hematoxylin eosin staining and H.pylori status by rapid urease test, culture and Warthin Starry silver staining.Degranulated and undegranulated mast cells in mucosa and submucosa were counted respectively.Results 78.8% of the DU patients and 53.3% of the patients with superfacial gastritis and 77.8% of the patients with erosive gastritis were H.pylori positive.The number of mast cells was not increased in the gastric mucosa with H.pylori infection,but the number of degranulated mast cells were significantly increased (23% vs 43%, P <0.05),which was closely associated with inflammatory activity in the gastric mucosa.No certain correlation was revealed between mast cell count and inflammation grade of the mucosa, but a significant difference was observed between the patients with active inflammation and those with non active inflammation (124/mm 2 vs 82/mm 2).The numbers of degranulated mast cell were also significantly increased in the patients with erosive gastritis and duodenal ulcer (18% and 23%).Conclusions It suggests that mast cell degranulation plays an important role in the development of gastric inflammation when H.pylori infection happened and that mast cell causes mucosal injury by releasing histamine and other proinflammatory mediators.