Yin Goang-Yao, Zhang Wu-Ning, He Xue-Fen, Chen Yi, Shen Xiao-Jing
Wuxi No.3 Peoples Hospital, 230 Eastern Tonghhui Road Wuxi 214041, Jiangsu Province, China.
World J Gastroenterol. 2003 Apr;9(4):836-42. doi: 10.3748/wjg.v9.i4.836.
To explore the pathophysiologibasis for the fact that patients with digestive tract symptoms do not necessarily have gastric mucosal pathology and those without clinical symptoms do not necessarily have no gastric mucosal pathology.
The ultrastructure, trace elements, cAMP, DNA, SOD and LPO in the gastric mucosa and its epithelial cells of 188 patients without organic lesions of heart, lung, liver, gallbladder, pancreas, kidney or intestine and basically histopathological normal persons (F) were detected synchronously by SEM, TEM, EDAX, Image analysis system RIA and (3)H-TdR Lymphocyte Transfer Test.
The content of Zn, Cu, cAMP and (3)H-TdR LCT in gastric mucosa and the content of Zn, Cu, DNA and LPO in gastric mucosa epithelial nuclei of each group were shown as belows: Normal control (4.1+/-1.0, 5.2+/-0.8, 15.9+/-1.5, 1079.7+/-227.4, 7.6+/-0.4, 58.4+/-0.3, 12.6+/-2.7, 2.6+/-0.6); CSG without symptoms group (3.7+/-1.2, 5.1+/-1.8, 15.6+/-0.9, 924.5+/-234.9, 7.8+/-0.3, 58.6+/-0.4, 13.0+/-3.1, 2.9+/-0.4); CAG without symptoms group (3.3+/-1.0, 4.8+/-0.9, 14.9+/-0.7, 887.7+/-243.6, 7.8+/-0.3, 58.7+/-0.3, 14.3+/-2.8, 3.1+/-0.4); F type with symptoms group (3.5+/-1.4, 4.5+/-1.0, 15.7+/-1.4, 932.1+/-2449.3, 7.9+/-0.4, 58.7+/-0.5, 13.5+/-4.6, 2.9+/-0.7); CSG with symptoms group (2.8+/-1.9, 4.0+/-1.5, 14.2+/-1.8, 867.3+/-240.5, 8.1+/-0.5, 58.9+/-0.5, 15.2+/-3.2, 4.2+/-0.7); CAG with symptoms group (2.0+/-1.8, 3.4+/-1.5, 13.4+/-1.8, 800.9+/-221.8, 8.6+/-0.4, 59.3+/-0.5, 16.5+/-3.1, 4.5+/-0.6). The contents of Zn, Cu in mitochonondria and SOD in gastric mucosa of each group were shown as belows: Normal control group (9.2+/-0.5, 58.3+/-0.3, 170.5+/-6.1), CSG without symptoms group (8.9+/-0.5, 58.2+/-0.3, 167.2+/-5.3), CAG without symptoms group (8.8+/-0.4, 57.5+/-0.2, 166.1+/-4.2); F type with symptoms group (8.9+/-0.5, 58.0+/-0.3, 167.9+/-5.7), CSG with symptoms group (8.6+/-0.5, 57.8+/-0.3, 163.3+/-5.6); CAG with symptoms group (8.3+/-0.4, 57.5+/-0.3, 161.2+/-4.3). There were significant differences in these cases, P<0.05-0.001. There were synchronous changes of gastric mucosa epithelial cellular ultrastructure. The "background lesions" (focal atrophic gastritis, focal intestinal metaplasia, micro-ulcer) in nonfocal gastric mucosa of all groups had significant differences (P<0.05-0.001).
Disease with symptoms, disease without symptoms, nondisease with symptoms occur on the basis of the quantitative changes of gastric mucosa epithelial cellular ultrastructure and related bioactive substances.
探讨消化道症状患者不一定存在胃黏膜病变，而无症状者不一定无胃黏膜病变这一现象的病理生理基础。
采用扫描电镜（SEM）、透射电镜（TEM）、能谱仪（EDAX）、图像分析系统、放射免疫分析（RIA）及³H-TdR淋巴细胞转化试验，同步检测188例无心脏、肺、肝、胆、胰、肾及肠道器质性病变且组织病理学基本正常者（F）胃黏膜及其上皮细胞的超微结构、微量元素、环磷酸腺苷（cAMP）、DNA、超氧化物歧化酶（SOD）及脂质过氧化物（LPO）。
各组胃黏膜中锌（Zn）、铜（Cu）、cAMP及³H-TdR淋巴细胞转化试验（LCT）含量，以及胃黏膜上皮细胞核中Zn、Cu、DNA及LPO含量如下：正常对照组（4.1±1.0，5.2±0.8，15.9±1.5，1079.7±227.4，7.6±0.4，58.4±0.3，12.6±2.7，2.6±0.6）；无症状慢性浅表性胃炎（CSG）组（3.7±1.2，5.1±1.8，15.6±0.9，924.5±234.9，7.8±0.3，58.6±0.4，13.0±3.1，2.9±0.4）；无症状慢性萎缩性胃炎（CAG）组（3.3±1.0，4.8±0.9，14.9±0.7，887.7±243.6，7.8±0.3，58.7±0.3，14.3±2.8，3.1±0.4）；有症状F型组（3.5±1.4，4.5±1.0，15.7±1.4，932.1±2449.3，7.9±0.4，58.7±0.5，13.5±4.6，2.9±0.7）；有症状CSG组（2.8±1.9，4.0±1.5，14.2±1.8，867.3±240.5，8.1±0.5，58.9±0.5，15.2±3.2，4.2±0.7）；有症状CAG组（2.0±1.8，3.4±1.5，13.4±1.8，800.9±221.8，8.6±0.4，59.3±0.5，16.5±3.1，4.5±0.6）。各组胃黏膜线粒体中Zn、Cu含量及SOD含量如下：正常对照组（9.2±0.5，58.3±0.3，170.5±6.1），无症状CSG组（8.9±0.5，58.2±0.3，167.2±5.3），无症状CAG组（8.8±0.4，57.5±0.2，166.1±4.2）；有症状F型组（8.9±0.5，58.0±0.3，167.9±5.7），有症状CSG组（8.6±0.5，57.8±0.3，163.3±5.6）；有症状CAG组（8.3±0.4，57.5±0.3，161.2±4.3）。这些情况差异有统计学意义，P<0.05 - 0.001。胃黏膜上皮细胞超微结构有同步变化。各组非病灶性胃黏膜中的“背景病变”（局灶性萎缩性胃炎、局灶性肠化生、微小溃疡）差异有统计学意义（P<0.05 - 0.001）。
有症状疾病、无症状疾病、有症状非疾病的发生是基于胃黏膜上皮细胞超微结构及相关生物活性物质的定量变化。
