【摘要】 目的探讨HIV感染后胃黏膜中免疫细胞增生、激活与疾病进展的关系。方法选取HIV感染且有胃黏膜组织活检标本的患者36例,另选非HIV感染者胃黏膜组织活检标本10例作为对照,利用免疫组织化学SP法检测研究对象胃黏膜活检组织中CD38、Ki-67的表达,并以Masson染色分析胶原沉积情况。结果与非HIV感染者(97.384±11.573)相比,HIV感染者胃黏膜中CD38表达(86.215±12.396)显著增多(P<0.01),无症状感染者与AIDS患者无显著差异(分别为82.954±10.725,79.982±12.443,P>0.05)。HIV感染者胃黏膜中Ki-67阳性细胞主要分布于胃小凹、固有层腺体和间质中。与非HIV感染者(20.933±2.719)相比,间质中Ki-67阳性免疫细胞(29.091±21.949)显著减少(P<0.01),无症状感染者与AIDS患者无显著差异(分别为27.985±4.650,29.328±7.343,P>0.05)。无症状感染者胃黏膜固有淋巴滤泡内Ki-67阳性细胞以淋巴细胞为主,但AIDS患者则以成纤维细胞等结缔组织细胞为主。AIDS患者胃黏膜间质及淋巴滤泡内有较多胶原纤维沉积,一些局部区域纤维间隔增多、增宽,无症状感染者胃黏膜间质及淋巴滤泡内胶原纤维沉积相对较少。结论 HIV感染后黏膜中免疫细胞激活与增生失衡,胶原沉积增加,这可能是AIDS发病的重要原因之一。更多还原

【Abstract】 Objective To investigate the relationship of the proliferation and activation of immunocytes in gastric mucosa with the disease progression in HIV-infected individuals.Methods Thirty-six HIV-infected individuals,and 10 persons without HIV infection serving as control,were enrolled in present study,and biopsy of gastric mucosal tissues was performed by fiberoptic gastroscopy.Immunohistochemistry(SP) was used to detect the expressions of CD38 and Ki-67 in gastric mucosa.Masson stain was used to observe collagen deposition in gastric mucosa.Results Compared with the non-infected controls,the expression of CD38 remarkably increased in HIV-infected individuals(97.384±11.573 vs 86.215±12.396,P<0.01),but there was no difference between asymptomatic HIV carriers and AIDS patients(82.954±10.725,79.982±12.443,P>0.05).In HIV-infected individuals,Ki-67 positive cells were mainly located in gastric foveola,lamina propria gland and stroma.As compared with the non-infected controls,Ki-67 positive immunocytes were remarkably decreased in stroma(20.933±2.719 vs 29.091±21.949,P<0.01),but there was also no significant difference between asymptomatic HIV carriers and AIDS patients(27.985±4.650,29.328±7.343,P>0.05).The Ki-67 positive cells were mostly lymphocytes in the lymphoid follicle of gastric mucosa in asymptomatic HIV carriers,while connective tissue cells such as fibroblasts were predominant in AIDS patients.There was more abundant collagen deposition in stroma and lymphatic follicles in AIDS patients than in asymptomatic HIV carriers.In AIDS patients,the follicle fibrous septum was found to be increased and widened in some region.Conclusion After HIV infection,the disequilibrium of activation and proliferation of immunocytes,as well as collagen deposition in mucosa,are probably the main pathogenetic factors of AIDS.更多还原