含奥美拉唑三联疗法治疗十二指肠溃疡后球部粘膜的超微结构

Ultrastructure in bulb mucosa of patients with duodenal ulcer after omeprazole triple therapy

目的 :观察十二指肠溃疡 (DU)病人球部粘膜的超微结构变化。方法 :10例DU伴幽门螺杆菌(Hp)感染病人 ,均应用奥美拉唑 2 0mg ,bid +克拉霉素 5 0 0mg ,bid +替硝唑 5 0 0mg ,po ,bid ,1wk ;治疗前及停药后 4～ 6wk ,应用电镜观察球部粘膜变化。结果 :治疗前球部粘膜上皮细胞坏死 ,细胞结构崩解 ,仅见一些难以辨认的细胞器 ;粘膜下层可见大量炎性细胞 ,主要是浆细胞及少量T淋巴细胞浸润。治疗后 ,可见上皮细胞的细胞核大、核 /质比高、核仁大而明显 ,分泌颗粒丰富 ,微绒毛完整 ,细胞质内各种细胞器清晰可见 ,腔面有较多粘液。结论 :含奥美拉唑三联疗法治疗后 ,粘膜上皮细胞具有正常细胞形态和结构 。

AIM: To observe the change of ultrastructure in bulb mucosa of patients with duodenal ulcer (DU). METHODS: Ten patients with active DU and Helicobactor pylori (Hp) infection (M 6, F 4; age 48 a± s 16 a), were treated with omeprazole 20 mg bid+clarithromycin 500 mg bid+tinidazole 500 mg bid triple therapy for 1 wk. The specimens were used to observe at ultrastructural level before the treatment or 4 6 wk after the end of the treatment. RESULTS: Prior to the treatment, ultrastructural results showed necrosis of epithelial cells in bulb mucosa, depletion of cellular structures, only some undistinguished organelles existed. Large quantities of inflammatory cells infiltrated into submucosal layer, for example, plasma cells,T lymphocytes. After triple therapy, ultrapathological studies indicated epithelial cells had big nueleus,increased ratio of nucleus/cytoplasma,big nucleolus,rich mucin granules, integral microvilli, lots of organelles in cytoplasma were easily observed, and much more mucin existed on the surface of epithelial cells. CONCLUSION: After omeprazole triple therapy, epithelial cells have normal cellular morphology and structure, and betterregenerated ability and active roles.