慢性十二指肠炎固有膜炎细胞计数、免疫荧光研究

目的 :探讨非特异性十二指肠炎 (NSD)的病变程度、分级方法及其与十二指肠溃疡病间的关系。方法 :对 6 4例上腹部不适的患者行胃镜检查 ,于十二指肠球部取材活检 ,进行固有膜炎症细胞计数及应用间接免疫荧光染色技术检测IgA、IgG在NSD粘膜中的分布。结果 :根据病变的程度 ,NSD被分为正常及轻、中、重三级 (0～Ⅲ )。炎细胞总数Ⅰ～Ⅲ级分别明显高于对照组 (0级 )。除Ⅰ级和浆细胞计数外 ,Ⅱ～Ⅲ级同 0级相比 ,统计学上差异有显著性 ;免疫荧光IgA、IgG在 0～Ⅲ级均有表达 ,IgA强度稍高。一例Ⅲ级病变 ,IgA、IgG均为阴性。结论 :本文研究结果显示 ,NSD是由多种病因引起的一种独立性的疾病 ,如果致病因素持续存在 ,NSD将在上皮糜烂、坏死脱落的基础上发展成十二指肠球部溃疡病

Study of Chronic Duodenitis with Inflammatory Cells Counts of Lamina Propria and Immunofluorescence Identification

Objective:To investigate extent of lesion, grading criteria of nonspecific duodenitis(NSD) and their association with duodenal ulceration.Methods: Using lamina propria inflammatory cells counts and indirect immunofluorescence technique, NSD was studied in endoscopic duodenal bulb biopsies taken from 64 cases with epigastric discomforts and the distribution of IgA、IgG were detected in the mucosa of NSD.Results: According to the extent of lesion, NSD was divided into the normal,mild, moderate and severe degrees (0～Ⅲ). The total inflammatory cells counts of lamina propria were obviously higher in degrees I～III than in degree 0. Compared to degree 0 there was significant statistical difference in degrees Ⅱ～Ⅲ (P< 0.05 and 0.01 respectively) except in degree I and plasma cells count. Fluorescence of IgA and IgG were positive in 0-Ⅲ degrees. IgA was stronger than IgG. In one severe case both IgA and IgG were negative.Conclusions:This article revealed that NSD is a distinct entity disease caused by multiple factors. If the pathogenetic factors remain, duodenal bulb ulceration may ensue on the basis of erosion and necrosis of mucosal epithelium.