重症肌无力患者胸腺肥大细胞的形态数量和超微结构研究

A quantitative analysis and an ultrastructural study of thymus mast cells in myasthenia gravis patients

为探讨研究重症肌无力（ＭＧ）患者胸腺内肥大细胞的形态数量和其超微结构变化与ＭＧ发病的关系。方法对２８例ＭＧ患者作胸腺肥大细胞的形态半定量分析和光镜观察，其中１６例的胸腺进行电镜检查。结果ＭＧ胸腺不仅表现组织学异常，且肥大细胞数量明显增多，尤其是在非增生胸腺内出现大量肥大细胞，而在增生的髓质和生发中心区几乎见不到。电镜观察提示肥大细胞与上皮细胞、Ｔ淋巴细胞和毛细血管关系密切，且含多种形态的分泌颗粒。结论肥大细胞对胸腺细胞的分化成熟、胸腺屏障和胸腺功能，以及ＭＧ发病均起到一定的重要作用。

Objective The authors made a study on the morphologic and quantitative changes of the thymus mast cells. Method A quantitative analysis of the thymus mast cells in 28 patients with myasthenia gravis (MG) and 16 cases of thymus tissues were examined with electron microscopy. Results The abnormal histological changes in the microenvironment of the MG thymus appeared and there were mast cell changes in a great number of the thymus glands of the MG patients with or without lymphocytes hyperplasia. However, few mast cells were seen in the hyperplastic medullary with the formation of the centre germinals. But mast cell counts were increased in MG patients than in non MG patients. In this ultrastructural study, the mast cells may be related to the epithelial cells, T cells, and the capillary of the thymus. In addition, various cytoplasmic granules of the mast cells were identified in the MG patients. Conclusions The authors are of the opinion that the mast cells may be related to blood thymus barrier, T cells differentiation and mature as well as the function of thymus, and which may play an important role in the MG pathogensis.