人体胃底腺组织学和壁细胞超微结构的增龄变化研究

Age-associated histological changes of fundic gland and ultrastructure of gastric parietal cells

摘要:

目的 研究人体胃底腺组织学及壁细胞超微结构的增龄变化。方法 选择拥有“相对正常胃”的 50例受试者作为研究对象，包括中青年组（20～59岁）19例和老年组（≥60岁）31例，其中老年组含60～69岁组11例, 70～79岁组10例, ≥80岁组10例。在光学显微镜下测定各组固有膜厚度（从上皮到黏膜肌层以上，不包括黏膜肌层）、胃底腺实质比和壁细胞比例，对比研究各组胃底腺形态，在电子显微镜下对比研究各组壁细胞超微结构。结果 光学显微镜下观察各组固有膜腺体的形态和细胞的分布无明显差异，但是定量测定老年组固有膜的厚度（892±172）μm明显低于中青年组（1014±203）μm（P＜0.05）；老年组胃底腺实质比例（83±10）%明显高于中青年组（80±7）%（P＜0.05）。壁细胞细胞数目占胃底腺细胞总数比例在各组间差异没有统计学意义。电子显微镜下观察各组胃壁细胞及与泌酸功能相关的细胞器形态分布无明显差异，定量测定线粒体面积分数，中青年组和老年组分别为（48±8）%和（51±8）%，差异无统计学意义（P＞0.05）；管泡系统面积分数，中青年组和老年组分别为（14±4）%和（12±5）%，差异无统计学意义（P＞0.05），各年龄组增龄变化亦无统计学差异。结论 胃底腺和壁细胞在数量和形态上没有发生明显退化，为阐明老年人仍有良好的泌酸功能提供了一定的科学依据。

Abstract:

Objective To investigate the age-associated histological changes of fundic gland and ultrastructure of gastric parietal cells. Methods Fifty subjects with a relative normal stomach were enrolled including 19 cases in younger group (aged 20-59) and 31 cases in elder group (≥60 years) . In the elder group, there were 11 cases aged from 60 to 69, 10 cases from 70 to 79 and 10 cases aged above 80. The histology and morphology of fundic gland was observed under a light microscope, including the lamina propria thickness (from the epithelium to the muscularis mucosa, without the muscularis mucosa) and the Np/Na ratio (Np means the number of gastric parietal cell, Na means the number of all cells in fundic gland), and the ultrastructure of gastric parietal cells was detected by electron microscope. Results No significant difference was showed in the histology and morphology of fundic gland. The average ratio of Np to Na did not differ between younger group and elder group. However, the thickness of lamina propria in elderly group（892±172）μm was significantly lower than that in younger group（1014±203）μm ( P＜0.05), while the average ratio Ap to Af (Ap means the area of parenchyma, Af means the area of high-power field) of elderly group （83±11）% was higher than that of younger group （80±7）% (P＜0.05). Furthermore, no significant difference was showed in the morphology of gastric parietal cell and acid-secretion-associated organelles among all the groups. Both the average ratio of Am to Ac (Am means the area of mitochondria, Ac means the area of cytoplasm of gastric parietal cell) and At to Ac (At means the area of secretory canaliculi and tubulovesicular system) do not associated with aging as there was no statistically significant difference between two groups [(48 ± 8)% vs (51 ± 8)%, P＞0.05; (14 ± 4)% vs (12 ± 5)%, P＞0.05)]. Conclusion The histology and morphology of acid-secretion tissue have no significant degeneration in the elderly. The results provide a scientific basis to clarify the well acid secretory function in the elderly.