不同反流物对食管上皮屏障的损伤研究

INJURY TO ESOPHAGEAL EPITHELIAL BARRIER OF GASTROESOPHAGEAL AND DUODENOESOPHAGEAL REFLUX

制作单纯胃食管反流 (G组 )、单纯十二指肠食管反流 (D组 )及十二指肠胃内容物混合食管反流 (DG组 )动物模型 ,对食管标本进行扫描电镜 (SEM)、透射电镜 (TEM)及镧示踪法电镜检查 ,以研究不同反流物对食管粘膜上皮屏障的损伤情况。结果显示 :G组见表层细胞脱落 ,细胞间桥粒明显减少 ,镧颗粒进入上皮细胞间隙 ,但未见进入细胞内 ;D组损害较严重 ,细胞表面微褶明显减少、不规则 ,细胞膜不连续 ,细胞器变性 ,镧颗粒可进入细胞间隙及胞质中 ;DG组兼见以上两种改变。提示胃液、十二指肠内容物反流都能造成明显的食管粘膜上皮屏障损害 ,但不同的反流物引起的上皮超微结构改变差别很大 ,其中十二指肠内容物的作用更为严重 ,值得重视。

Models of gastroesophageal reflux(G group), duodenoesophageal reflux(D group) and duodenogastroesophageal reflux(DG group),were made by operations. The esophageal samples were studied by scanning and transmission electron microscopy and Lanthanum trace labeling. The results showed that all rats in reflux groups had ultrastructure changes in esophageal epithelium. Gastroesophageal reflux affected primarily the intercellular substance while duodenoesophageal reflux resulted in changes of the cell membrane and intracellular organelles. The changes in G group were fewer than those in D group. It is suggested that both of gastric juice and duodenal contents refluxing into esophagus can injury esophageal epithelial barrier.The differences of ultrastructure change in different groups are significant and the changes in D group are more severe.