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目的应用多种形态学手段在细胞、亚细胞及大分子水平上观察幽门螺杆菌（Ｈｐ）感染后胃粘膜屏障的改变，进一步探讨Ｈｐ感染的发病机制。方法尿素酶试验阳性的胃粘膜活检标本４０例，处理如下：（１）常规ＨＥ、ＡＢ／ＰＡＳ、Ｗ－Ｓ法染色，观察胃粘膜病变及其与Ｈｐ数量、ＰＭＮ浸润程度的相关性。（２）透射电镜观察Ｈｐ与胃粘液细胞的粘附情况以及粘液细胞超微结构改变。（３）单宁酸染色后透射电镜观察并计算暗／明细胞（Ｄ／Ｌ）的比值，以判断细胞膜对大分子物质通透性的改变。（４）其中６例标本经冷冻蚀刻技术处理后，复型膜透射电镜观察胃粘液细胞间紧密连接的变化。（５）ＰＥＩ染色后透射电镜观察胃粘液细胞游离面、Ｈｐ表面以及Ｈｐ与胃粘液细胞接触处阴离子分布的变化。结果（１）粘液细胞病变程度、粘液减少程度与Ｈｐ的数量及ＰＭＮ浸润程度均呈正相关（Ｐ＜０．０１或Ｐ＜０．０５）。（２）电镜下Ｈｐ分布在不同的粘液细胞表面多少不一，部分细胞表面微绒毛丢失，粘液颗粒减少，有些细胞表面呈火山口样改变，部分细胞浆内次级溶酶体增多，有时可见空泡形成。（３）单宁酸染色示Ｈｐ感染后部分粘液细胞的质膜对大分子物质的通透性增大，且Ｄ／Ｌ值与Ｈｐ的数量、ＰＭＮ浸润程度及粘液?
Objective To observe the changes of gastric mucosal barrier after Helicobacter pylori (Hp) infection by using a variety of morphological means at the cellular, subcellular and macromolecular levels to further explore the pathogenesis of Hp infection. Methods Forty patients with positive gastric mucosal biopsy specimens were treated with the following methods: (1) routine HE, AB / PAS and W-S staining were used to observe the gastric mucosal lesions and their relationship with the number of Hp and the infiltration of PMN. (2) Transmission electron microscopy was used to observe the adhesion of Hp to gastric mucus cells and ultrastructural changes of mucous cells. (3) After tannic acid staining, the ratio of dark / bright cells (D / L) was observed by transmission electron microscopy to determine the change of cell membrane permeability to macromolecules. (4) Six cases of specimens were treated by freeze-etching technique, and the changes of tight junctions in gastric mucus cells were observed by transmission electron microscopy. (5) The changes of anion distribution of gastric mucosal cell free surface, Hp surface and Hp contact with gastric mucus cells were observed by PEI after TEM examination. Results (1) The degree of mucus cytopathicity and mucus reduction were positively correlated with the number of Hp and infiltration of PMN (P <0.01 or P <0.05). (2) The distribution of Hp on the surface of mucus cells under electron microscope was somewhat different. The microvilli on the surface of some mucus cells were lost and the number of mucus particles was decreased. Some of the cells changed calvaria-like surface, some of the cytoplasm increased secondary lysosomes, Cavitation formation. (3) Tannic acid staining showed that the permeability of plasma membrane to some macromolecules increased after Hp infection, and the number of D / L and Hp, the infiltration of PMN and mucus?