Sarosiek J, Marshall B J, Peura D A, Hoffman S, Feng T, McCallum R W
University of Virginia Health Sciences Center, Department of Medicine, Charlottesville.
Am J Gastroenterol. 1991 Jun;86(6):729-34.
The gastroduodenal mucus layer is considered the primary mucosal protective barrier, especially important in the maintenance of a mucosal pH gradient. Thus, the measurement of the mucus layer thickness in various disease states could advance our understanding of gastroduodenal pathophysiology. We present a novel method for measuring the mucus layer in endoscopic biopsy material and compare layer thickness in Helicobacter pylori (HP)-negative and HP-positive specimens. Endoscopic biopsies were obtained from 17 patients with gastroduodenal mucosa harboring HP and from 15 patients without current HP colonization. The thickness of the mucus layer was measured in fresh specimens by the phase-contrast dark-field microscopy technique. In patients with confirmed HP infection, the thickness of the mucus layer (mean +/- SD) was 0.093 +/- 0.033 mm in duodenal, 0.085 +/- 0.027 mm in antral, and 0.105 +/- 0.033 mm in corporal mucosa. In patients without concomitant HP colonization, the thickness of the mucus gel was 0.162 +/- 0.045 mm, 0.175 +/- 0.067 mm, and 0.161 +/- 0.064 mm in duodenum, antrum, and corpus, respectively. The differences between the means were statistically significant (p less than 0.001 for the duodenal, p less than 0.001 for antral, and p less than 0.01 for corporal mucosa). This study suggests that colonization of the gastroduodenal mucosa by HP impairs the mucus layer covering the surface epithelium. This mucus layer impairment may lead to mucosal injury with subsequent development of inflammation and, possibly, peptic ulcer disease.
胃十二指肠黏液层被认为是主要的黏膜保护屏障，在维持黏膜pH梯度方面尤为重要。因此，测量不同疾病状态下的黏液层厚度有助于我们深入了解胃十二指肠的病理生理学。我们提出了一种在内镜活检材料中测量黏液层的新方法，并比较了幽门螺杆菌（HP）阴性和HP阳性标本中的黏液层厚度。从17例胃十二指肠黏膜存在HP的患者和15例目前无HP定植的患者中获取内镜活检组织。通过相差暗视野显微镜技术测量新鲜标本中黏液层的厚度。在确诊为HP感染的患者中，十二指肠黏液层厚度（平均值±标准差）为0.093±0.033mm，胃窦部为0.085±0.027mm，胃体部为0.105±0.033mm。在无HP定植的患者中，十二指肠、胃窦和胃体部的黏液凝胶厚度分别为0.162±0.045mm、0.175±0.067mm和0.161±0.064mm。平均值之间的差异具有统计学意义（十二指肠p<0.001，胃窦部p<0.001，胃体部黏膜p<0.01）。本研究表明，HP在胃十二指肠黏膜的定植会损害覆盖表面上皮的黏液层。这种黏液层损伤可能导致黏膜损伤，随后引发炎症，甚至可能发展为消化性溃疡疾病。
