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目的 :通过对胃粘膜超微结构观察 ,了解糖尿病人胃粘膜微血管及胃固有腺体的变化特点 ,探讨胃粘膜微血管的变化与糖尿病胃病及其它重要合并症的联系。方法 :选择2 0例临床没有或仅有轻微症状的NIDDM病人 ,4例无糖尿病及胃病的志愿者作对照组 ,取胃窦部及胃体部粘膜组织各二份 ,进行透射电镜观察。结果 :全部被观察病例微血管内皮细胞均有不同程度的肿胀 ,基底膜增厚。微血管轻度变化 2例 ,中度变化 16例 ,重度变化 2例。壁细胞内线粒体数目不同程度地减少 ,部分线粒体肿胀 ,少数线粒体高度肿胀、脊断裂 ,壁细胞分泌小管减少或萎缩。10例有 1种以上合并症者 (糖尿病肾病、视网膜病变、神经病变 )微血管损伤均在中度以上。结论 :糖尿病胃粘膜微血管的损伤是糖尿病性胃病的重要病理基础。
OBJECTIVE: To observe the changes of gastric mucosal microvessels and gastric intrinsic glands in gastric mucosa by observing the ultrastructure of gastric mucosa, and to explore the relationship between the changes of gastric mucosal microvessels and diabetic gastropathy and other important complications. Methods: Twenty patients with NIDDM who did not have clinical symptoms or mild symptoms and 4 volunteers who did not have diabetes mellitus and stomach were selected as the control group. Two mucosa of gastric antrum and gastric body were selected and observed by transmission electron microscopy. Results: All observed microvascular endothelial cells have varying degrees of swelling, thickening of the basement membrane. Mild microvascular changes in 2 cases, moderate changes in 16 cases, severe changes in 2 cases. The numbers of mitochondria in parietal cells decreased to some extent, some mitochondria were swollen, a few of mitochondria were highly swollen, spinal rupture, parietal cells secreted tubules decreased or atrophied. 10 cases had more than one kind of comorbidities (diabetic nephropathy, retinopathy, neuropathy) microvascular damage were more than moderate. Conclusion: Diabetic gastric mucosal microvascular damage is an important pathological basis of diabetic gastropathy.