Zoli G, Bonvicini F, Ercoli C, Gasbarrini G, Laschi R
Acta Physiol Hung. 1984;64(3-4):385-92.
We applied scanning electron microscopy (SEM) to the study of duodenal ulcer healing during treatment with an H2-receptor antagonist (ranitidine). We also evaluated the changes in the duodenal mucosa close to the lesion, which appeared endoscopically and histologically normal. Endoscopic biopsies were taken from 8 patients both on the edge of the ulcer and in the upper duodenum, before and after 1, 2, 3, 4 and 8 weeks of treatment. Endoscopy revealed a decrease of the ulcer crater after the first week and a complete healing after three weeks of therapy. The ulcer edge presented a subtotal mucosal atrophy, cellular exfoliation (dome-shaped cells) and changes in microvilli (bridging, branching, blebs). In the first week of treatment, reepithelization was observed: however, cellular exfoliation and changes in microvilli persisted at least up to the end of the first month of treatment. Short and stumped villi began to reappear after one month. The mucosa farthest from the lesion showed the same alterations but to a lesser extent. The changes tended to decrease after treatment. Two months after the end of treatment the duodenal mucosa was endoscopically and histologically normal, while SEM showed altered microvilli. SEM allowed us to investigate the morphogenesis of mucosal repair and to identify minimal cellular alterations which could represent the morphological basis of the disease and its possible recurrence.
我们应用扫描电子显微镜（SEM）来研究十二指肠溃疡在使用H2受体拮抗剂（雷尼替丁）治疗期间的愈合情况。我们还评估了溃疡病灶附近十二指肠黏膜的变化，这些黏膜在内镜检查和组织学检查中均显示正常。在治疗的第1、2、3、4和8周之前及之后，从8例患者的溃疡边缘和十二指肠上段取内镜活检组织。内镜检查显示，治疗第一周后溃疡 crater 减小，治疗三周后完全愈合。溃疡边缘呈现黏膜部分萎缩、细胞脱落（穹顶状细胞）和微绒毛改变（桥接、分支、泡状）。在治疗的第一周观察到上皮再生：然而，细胞脱落和微绒毛改变至少持续到治疗的第一个月末。一个月后短而残的绒毛开始重新出现。离病灶最远的黏膜显示出相同的改变，但程度较轻。治疗后这些改变趋于减轻。治疗结束两个月后，十二指肠黏膜在内镜检查和组织学检查中均正常，而SEM显示微绒毛改变。SEM使我们能够研究黏膜修复的形态发生，并识别可能代表疾病形态学基础及其可能复发的微小细胞改变。
