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采用组织化学、放射免疫和能量色散X射线分析方法在55例脾虚证胃病患者中研究4种不同类型的胃粘膜肠化生和胃粘膜cAMP和微量元素。肠化生率、结肠型肠化生率、不完全性结肠型肠化生率和胃癌率随着脾气虚证和脾虚气滞证的顺序而递增,胃粘膜cAMP和Zn含量则分别随着相同的脾虚证、完全性和不完全性小肠型和结肠型肠化生,良性胃病和胃癌的顺序而递减,统计学差异也有意义,P<0.05-0.001。所有这些发现提示胃粘膜cAMP和Zn的量变和不完全性结肠型肠化生与脾虚证胃癌密切相关。胃粘膜cAMP和Zn含量变化可能是脾虚证胃病演化过程中病理生理和病理组织反应的物质基础。测定cAMP和Zn含量及肠化生类型在估计病程和疗效上可有重要临床意义。
Seven types of gastric mucosal intestinal metaplasia and cAMP and trace elements in gastric mucosa were studied in 55 patients with spleen-deficiency stomach syndrome using histochemical, radioimmunoassay, and energy dispersive X-ray analysis. The rate of intestinal metaplasia, intestinal metaplasia of colon, intestine metaplasia of incomplete colon and gastric cancer rate increase with the order of spleen qi deficiency syndrome and spleen qi stagnation syndrome. The contents of cAMP and Zn in gastric mucosa are the same. Spleen asthenia, completeness and incomplete intestinal and colonic intestinal metaplasia, benign gastropathy, and gastric cancer were in decreasing order, with statistical significance also significant, P<0.05-0.001. All these findings suggest that the changes of gastric mucosal cAMP and Zn levels and incomplete colonic intestinal metaplasia are closely related to spleen deficiency syndrome and gastric cancer. Changes in cAMP and Zn content in the gastric mucosa may be the material basis for pathophysiological and histopathological reactions during the evolution of spleen deficiency stomach syndrome. Determination of cAMP and Zn levels and intestinal metaplasia may have important clinical implications in estimating the course of disease and efficacy.