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采用常规胃镜下十二指肠降部粘膜活检，对降部粘膜绒毛组织学及微绒毛超微结构进行观察并行相应图像定量分析。营养性贫血组２１例，包括９例巨幼细胞贫血，１２例缺铁性贫血，其中６例行电镜观察。对照组２６例，其中１１例行电镜观察。结果，营养性贫血组绒毛长度显著缩短（Ｐ＜０．０１），绒毛宽度显著增宽（Ｐ＜０．０１），隐窝深度明显加深（Ｐ＜０．０１），本组多有不同程度的萎缩，中、重度萎缩占１４／２１（χ￣２＝６．０１，Ｐ＜０．０５）。组织学观察还可见不同程度的绒毛融合、扭曲和消失，核增大，粘膜下炎性细胞浸润。其中７例贫血纠正后复查十二指肠降部，粘膜活检表明粘膜萎缩和炎症程度明显减轻（Ｐ＜０．０１）。超微结构及图像定量观察表明微绒毛密度稀疏（Ｐ＜０．０１）、高度减低（Ｐ＜０．０１），表面积缩小（Ｐ＜０．０１），其它可见微绒毛长短不一、排列不齐、融合及萎缩、核变大。结果揭示了从绒毛到微绒毛的一系列改变，表明营养性贫血可以引起吸收不良的病理改变，纠正贫血后这种改变是可以恢复的。
The routine endoscopic descending duodenal mucosal biopsy was used to observe the histology and microvilli ultrastructure of the descending mucosa and to analyze the corresponding images quantitatively. Nutritional anemia in 21 cases, including 9 cases of megaloblastic anemia, 12 cases of iron deficiency anemia, of which 6 cases were observed by electron microscopy. Control group, 26 cases, of which 11 cases were observed by electron microscopy. Results: The length of villus in nutritional anemia group was significantly shortened (P <0.01), villus width was significantly broadened (P <0.01), crypt depth was significantly deepened (P <0.01) Of the atrophy, moderate and severe atrophy accounted for 14/21 (χ ~ 2 = 6.01, P <0.05). Histological observation also shows varying degrees of villus fusion, distortion and disappearance, nuclear enlargement, submucosal inflammatory cell infiltration. Seven cases of anemia were corrected after re-examination of the descending part of the duodenum. Mucosal biopsy showed that mucosal atrophy and inflammation were significantly reduced (P <0.01). The ultrastructure and the quantitative observation of the images showed that the density of microvilli was sparse (P <0.01), the height was decreased (P <0.01) and the surface area was reduced (P <0.01) Qi, fusion and atrophy, nuclear become larger. The results revealed a series of changes from villus to microvilli suggesting that nourishing anemia can cause pathological changes of malabsorption and that such changes are recoverable after the anemia is corrected.