肝硬化门脉高压性胃病临床分析  

Clinical analysis on portal hypertensive gastropathy in patients with hepatocirrhosis

作　　者：耿楠[1] 马冰[1] 陈新月[1] 马丽娜[1] 

机构地区：[1]首都医科大学附属北京佑安医院特需科,北京100069

出　　处：《中国实验诊断学》2008年第6期753-756,共4页Chinese Journal of Laboratory Diagnosis

摘　　要：目的探讨肝硬化门脉高压性胃病的临床特点。方法回顾性分析41例临床诊断为乙型肝炎肝硬化患者的临床资料,依据胃镜下是否存在门脉高压性胃病,将其分为PHG组和非PHG组,对二组资料的血常规、肝脏生化、凝血功能、T淋巴细胞亚群、B超及胃镜检查结果进行统计学分析。结果41例肝硬化患者中PHG共14例,占34.1%。PHG组与非PHG组胃底静脉曲张程度(χ2=10.342,P=0.001),胃底静脉重度曲张伴红色征阳性(χ2=10.342,P=0.001),食管静脉重度曲张伴红色征阳性(χ2=3.873,P=0.049),食管胃底静脉重度曲张伴红色征阳性(χ2=3.873,P=0.049),RDW(t=-2.322,P=0.026),MPV(t=2.149,P=0.038),PTA(t=2.064,P=0.046),CD3+计数(t=3.292,P=0.017)、CD4+计数(t=3.642,P=0.011)及脾脏厚度(t=-2.952,P=0.005)、脾长径(t=-2.241,P=0.031)、门静脉内径(t=-2.177,P=0.044)及脾静脉内径(t=-2.235,P=0.031)等差异具有显著性意义,而二组间白细胞计数、血小板计数、肝脏生化、Child-pugh评分及分级等差异无显著性(P>0.05)。结论(1)门静脉高压与肝功能下降均是PHG发生的重要因素。(2)PHG常伴有机体免疫紊乱。(3)PHG与胃底静脉曲张程度相关。Objective To study the clinical characteristics of PHG in patients with hepatocirrhosis.Methods 41 patients with hepatocirrhcsis were divided into two groups which are signed by PHG, analysis the clinical flies, such as hloed Rt, liver biochemistry, hemoglutination function, T lymphocyte subgroup, UCG of liver and gastroseope of the two groups.Results There are 14 PHG cases in all 41 patients with hepatocirrhosis,The disease incidence rate is 34.1% .In PHG group and non-PHG group,varicosity degree of fun- dus（ X^2= 10.342, P = 0.001）, serious varicosity of fundus with RC（ ＋ ） （ X^2 = 10.342, P = 0. 001 ）, serious varicosity of esophagus with RC （ ＋ ） （ X^2 = 3.873, P = 0.049）, serious varicosity of esophagus-fundus （ X^2 = 3.873, P = 0.049）, RDW（ t = - 2.322, P = 0.026）, MPV（ t = 2.149, P = 0.038）, PTA（ t = 2.064, P = 0.046）, CD3^＋ count（ t = 3.292, P = 0.017）, CD4^＋ count（ t = 3.642, P = 0.011）, thickness of spleen（ t = - 2.952, P = 0.005）, length of spleen（ t = - 2.241, P = 0.031 ）, PV（ t = - 2.177, P = 0.044）,SV（t= -2.235,P=0.031）had obviously difference,others had no obviously difference. Conclusion （1）Both portal hypertensive and liver function decrease are the important causes of PHG. （2） PHG often along with the immune function imbalance. （3） PHG has relations with the varicosity degree of fundus.

关 键 词：肝硬化 门脉高压性胃病 食管静脉曲张 

分 类 号：R575.2[医药卫生—消化系统]