幽门螺杆菌感染对胃粘膜超微结构的影响

目的研究幽门螺杆菌（Ｈｐ）感染及其根除前后胃粘膜超微结构的变化．方法Ｈｐ感染患者１０例经三联疗法２８ｄ．Ｈｐ阴转７例于停药１月后及治疗前内镜下取胃窦粘膜，经切片染色后分别行透射电镜及扫描电镜观察．结果透射电镜显示，Ｈｐ聚集处上皮细胞微绒毛变短、减少或消失，细胞呈毛刺状或外突形成分枝状，细胞膜内侧粘液颗粒聚集，细胞破裂，释放粘液颗粒．扫描电镜下Ｈｐ横卧于微绒毛表面或垂直镶嵌在微绒毛里．应用三联疗法（德诺１２０ｍｇ＋四环素０２５ｇ＋呋喃唑酮１０ｍｇ，４次／ｄ）治疗２８ｄ，停药１月后７例Ｈｐ根除．电镜显示Ｈｐ消失，粘膜细胞变性逆转，上皮细胞及微绒毛结构恢复正常．结论Ｈｐ引起的胃粘膜超微结构损害在根除Ｈｐ后有改善及恢复

Ultrastructural study of gastric mucosa pre_and post_eradication of Helicobacter pylori infection

AIM To study the ultrastructural changes of gastric mucosa pre_ and post_eradication of Helicobacter pylori (Hp) infection. METHODS Gastric antral mucosa biopsies in 10 patients with Hp infection, 7 of whom became Hp negative one month after the triple therapy (de_nol 120mg, tetracycline 0 25g, furanzolidone 10mg, four times a day, for 28 days), were fixed, embedded, sectioned and stained for electron microscopic observation. RESULTS Transmission electron microscopy showed that the microvilli of the epithelium were shortened, decreased or disappeared at the Hp infection sites, and the cell membranes were filled with hairy sticks or various branched protrusions like pseudopodium, and mucous granules aggregated in the inner side of the membrane, some fused from larger granules. Scanning electron microscopy showed Hp clustering in the intercellular areas. Biopsies after the triple therapy one month later showed complete disappearance of the bacilli and recovery of the epithelium. CONCLUSION Ultrastructural changes associated with Hp infection can be improved or normalized after Hp eradication.