Batman P A, Miller A R, Forster S M, Harris J R, Pinching A J, Griffin G E
Department of Histopathology, St George's Hospital Medical School, London.
J Clin Pathol. 1989 Mar;42(3):275-81. doi: 10.1136/jcp.42.3.275.
Jejunal biopsy specimens from 20 human immunodeficiency virus (HIV) positive male homosexual patients were analysed and compared with those of a control group to determine whether the abnormalities were caused by the virus or by opportunistic infection. The degree of villous atrophy was estimated with a Weibel eyepiece graticule, and this correlated strongly with the degree of crypt hyperplasia, which was assessed by deriving the mean number of enterocytes in the crypts. The density of villous intraepithelial lymphocytes fell largely within the normal range, either when expressed in relation to the number of villous enterocytes or in relation to the length of muscularis mucosae. Villous enterocytes showed mild non-specific abnormalities. Pathogens were sought in biopsy sections and in faeces. Crypt hyperplastic villous atrophy occurred at all clinical stages of HIV disease and in the absence of detectable enteropathogens. An analogy was drawn between HIV enteropathy and the small bowel changes seen in experimental graft-versus-host disease. It is suggested that the pathogenesis of villous atrophy is similar in the two states, the damage to the jejunal mucosa in HIV enteropathy being inflicted by an immune reaction mounted in the lamina propria against cells infected with HIV.
对20名男性同性恋人类免疫缺陷病毒（HIV）阳性患者的空肠活检标本进行分析，并与对照组的标本进行比较，以确定这些异常是由病毒还是机会性感染引起的。用韦贝尔目镜测微计估计绒毛萎缩程度，其与隐窝增生程度密切相关，隐窝增生程度通过计算隐窝中肠上皮细胞的平均数来评估。无论是相对于绒毛肠上皮细胞数量还是相对于黏膜肌层长度，绒毛上皮内淋巴细胞密度大多在正常范围内。绒毛肠上皮细胞表现出轻度非特异性异常。在活检切片和粪便中寻找病原体。在HIV疾病的所有临床阶段均出现隐窝增生性绒毛萎缩，且未检测到肠道病原体。有人将HIV肠道病与实验性移植物抗宿主病中所见的小肠变化进行了类比。有人认为，这两种状态下绒毛萎缩的发病机制相似，HIV肠道病中空肠黏膜的损伤是由固有层针对感染HIV的细胞产生的免疫反应所致。
