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Whipple’s病患者的十二指肠在内窥镜下的异常表现以及临床症状,与在光镜及电镜下小肠上皮细胞的正常表现相左。内窥镜下包括具有白斑、红斑、糜烂或轻度的粘膜溃疡的改变和消化道出血、贫血、腹泻、吸收不良等症状,提示小肠上皮有损伤。但是除了在电镜下观察到Whipple杆菌外,小肠上皮细胞在光镜及电镜下表现出惊人的正常。但是,小肠上皮皱褶有所改变,如:细胞有胞浆空泡形成,胞体变短及偶尔变平的趋势;同时,治疗证明这些改变和刷状缘的消失是可逆的。这说明炎性改变依然存在,而且以往的研究结果亦不尽相同。
The abnormalities and clinical signs of the duodenum in Whipple’s disease under endoscopy are in contrast to the normal appearance of small intestinal epithelial cells under light and electron microscopy. Endoscopy including white spots, erythema, erosion or mild mucosal ulcer changes and gastrointestinal bleeding, anemia, diarrhea, malabsorption and other symptoms, suggesting damage to the small intestine epithelium. However, in addition to the observation of the WhiBiobacillus under electron microscopy, the small intestine epithelial cells showed strikingly normal under light and electron microscopy. However, folds in the small intestine changed, such as the formation of cytoplasmic vacuoles, a shortened and sometimes flattened cell body, and at the same time, treatment proved that these changes and the disappearance of the brush border were reversible. This shows that inflammatory changes still exist, and the results of previous studies are not the same.