|
|
|
| Ultrastructural changes of duodenal mucosa in patients with malnutrition and its significance |
| ZHU Hai-yan WU Xiong-jian |
| Department of Gastroenterology,the First Affiliated Hospital of Gannan Medical University,Jiangxi Province,Zhangzhou 341000,China |
|
|
|
|
Abstract Objective To observe the ultrastructural changes of duodenal mucosa in malnourished patients and explore its significance.Methods Eighteen patients with malnutrition due to ingestion disorders performed with nasogastric cathelerization or nasojejunal cathelerization under electronic gastroscopy in our hospital from October 2012 to May 2015 were selected.Conventional endoscopic biopsy was performed during electronic gastroscopy for patient's duodenal mucosa,which was examined by transmission electron microscope to observe its ultrastructure.The malnutrition patients with or without ultrastructural changes in duodenal mucosa were classified into positive and negative groups,respectively.The levels of plasma hemoglobin,total protein,albumin,prealbumin and transferrin were tested in the two groups.The relationship between ultrastructural changes of duodenal mucosa and the above indexes were analyzed.Results Of 18 patients,10 were detected with ultrastructural changes of duodenal mucosa,and the incidence was 55.6%.The ultrastructural changes of duodenal mucosa were manifested as sparse microvilli of epithelial cells in disorganized arrangement,widened intercellular junction space and swollen organelles.The levels of plasma albumin and transferrin decreased significantly in the positive group compared with those in the negative group (P＜0.05),but the levels of hemoglobin,total protein and prealbumin were not significantly different(P＞0.05).Conclusion There are ultrastructural changes of duodenal mucosa in patients with malnutrition,and the changes are of great significance for reflecting patient's nutritional status,intestinal environment and function.
|
|
|
|
|
|
| [1] |
Toussaint E，Van Gossum A，Ballarin A，et al.Enteral access in Adults[J].Clin Nutr，2015，34（3）：350-358.
|
| [2] |
傅廷亮，张文同，陈强谱，等.肠内营养对梗阻性黄疸幼鼠肠黏膜结构的影响[J].中华小儿外科杂志，2006，27（3）：166-168.
|
| [3] |
鱼晓波，柴小军，黄海龙，等.早期肠内营养对食管癌术后患者肠黏膜屏障及细菌移位的影响[J].海南医学，2012，23（20）：11-14.
|
| [4] |
邱远，杨桦.营养支持治疗在重症患者肠功能维护中的作用[J].临床外科杂志，2016，24（12）：889-892.
|
| [5] |
李宁.肠功能障碍的营养支持[J].中华胃肠外科杂志，2002，5（3）：175-176.
|
| [6] |
汪志明.肠内营养支持途径的建立与管理[J].肠外与肠内营养，2017，24（2）：68-71.
|
| [7] |
韦志坤，程爱国.肠黏膜细胞的紧密连接与肠壁通透性的研究进展[J].世界华人消化杂志，2011，19（4）：394-399.
|
| [8] |
吕宾.肠黏膜屏障与肠功能障碍[J].现代消化及介入诊疗，2013，18（4）：232-234.
|
| [9] |
Magnotti LJ，Deitch EA.Burns，bacterial translocation，gut barrier function，and failure[J].J Burn Care Rehabil，2005，26（5）：383.
|
| [10] |
Patrick DM，Leone AK，Shellenberger JJ，et al.Proinflammatory cytokines tumor necrosis factor-αand interferon-γ modulate epithelial barrier function in Madin-Darby canine kidney cells through mitogen activated protein kinase signaling[J].BMC physiology，2006，6（1）：2.
|
| [11] |
贾云鹤，江志伟，李宁，等.癌性营养不良小鼠肠黏膜损伤与炎症反应相关性研究[J].肠内与肠外营养.2009，16（3），167-169.
|
| [12] |
李宁.肠功能障碍与营养支持[J].临床外科杂志，2006，14（4）：199-201.
|
| [13] |
谢小薰，孔力.组织学与胚胎学[M].北京：高等教育出版社，2015.
|
| [14] |
李玉林.病理学[M].第8版.北京：人民卫生出版社，2013.
|
| [15] |
邓平非，贾太和，何绮娜，等.吸收不良综合征患者十二指肠纹缘上皮细胞微绒毛超微结构与图像分析[J].临床与实验病理学杂志，1994，1（1）：15.
|
|
|
|
