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81例脾虚证患者胃粘膜活检组织,电镜观察其植物神经终末超微结构的变化,对胆碱能终末内的乙酰胆碱(ACh)小泡进行了体视学定量分析,并通过放免方法测定患者血浆cAMP、cGMP含量,发现不同证型的脾虚患者之间有明显的差异;脾虚气滞型患者胆碱能神经终末中ACh小泡的数目显著多于脾胃气虚型(P<0.01);血浆cGMP含量明显高于脾胃气虚型和健康对照组(P<0.02),cAMP/cGMP比值则明显低于后两组(P<0.005～0.001)。本实验从超微结构水平研究了胃粘膜层胆碱能神经末的形态,提出了脾虚气滞型患者胆碱能神经偏亢的形态学依据。此外胃粘膜电镜活检可以作为观察胃肠植物神经功能状态的一个可靠的形态学方法。
The biopsy of gastric mucosa in 81 patients with spleen-deficiency syndrome was observed by electron microscopy. The ultrastructure of autonomic nerve endings was observed by electron microscopy. Stereological quantitative analysis of acetylcholine (ACh) vesicles in the cholinergic terminal was performed and determined by radioimmunoassay. The plasma levels of cAMP and cGMP were found to be significantly different among patients with different syndromes of spleen deficiency. The number of ACh vesicles in cholinergic nerve terminals was significantly greater than that of spleen and stomach qi deficiency in patients with spleen deficiency and stagnation (P<0.01). Plasma cGMP levels were significantly higher than spleen and stomach qi deficiency and healthy controls (P<0.02), and cAMP/cGMP ratios were significantly lower than those of the latter two groups (P<0.005-0.001). In this experiment, the morphology of cholinergic nerve endings in gastric mucosa was studied from the ultrastructural level, and the morphological basis of cholinergic nerve paralysis in patients with spleen deficiency and qi stagnation was proposed. In addition, gastric mucosal electron microscopy can be used as a reliable morphological method to observe the state of gastrointestinal autonomic function.