胰源性与特发性门脉高压症的临床特点分析  

Clinical characteristics of pancreatic portal hypertension and idiopathic portal hypertension

作　　者：赵琦[1] 杨善美 张爱侠[3] 王瑞春[3] 冯红霞[1] 李振方[3] 

机构地区：[1]聊城市人民医院脑科分院,山东聊城252000 [2]莱钢总医院,山东莱州271100 [3]聊城市人民医院消化内科,山东聊城252000

出　　处：《临床肝胆病杂志》2010年第2期208-209,共2页Journal of Clinical Hepatology

摘　　要：目的探讨PPH与IPH的临床特点,加深对二者的认识,提高临床医师的诊治水平。方法对18例PPH与36例IPH患者的临床资料作一回顾分析。结果二者的肝脏形态、功能正常,病毒学指标阴性,超声检查脾静脉迂曲扩张,脾肿大;PPH患者超声检查门静脉正常,胰腺可见炎症、肿瘤、囊肿等表现;IPH患者门静脉及肠系膜上静脉迂曲扩张,但胰腺方面无异常。IPH患者汇管区纤维组织增生和炎性细胞浸润但无肝硬化改变而PPH患者肝脏组织学正常。结论临床中发现肝脏形态、功能正常,病毒学指标阴性,以门脉高压为主要表现而无肝硬化改变的患者,应考虑IPH与PPH的可能。进一步行超声检查门脉系统及胰腺情况,可进一步区分二者。Objective To analyze the clinical characteristics of pancreatic portal hypertension （PPH）and idiopathic portal hypertension（IPH）.Methods The clinical data of 18 PPH and 36 IPH cases were analysed.Results The liver size and liver function tests such as ALT,AST and GGT were normal and viral indexes were negative in both groups.Ultrasound examination revealed splenomegaly,dilation and tortuosity of spleenic vein.The diameter of portal vein and superior mesenteric veins were wide in IPH whereas,normal in PPH.There were pancreatic diseases such as pancreatitis and tumor in PPH patients.Portal area fibrosis and inflammatory cell infiltrations were seen in patients with IPH whereas histopathology was normal in patients with PPH.Conclusion IPH and PPH should be considered when portal hypertension patients are presented with normal liver function and normal liver size in clinical practice.Ultrasound examination of portal vein,superior mesenteric vein and pancreas is important to provide definite diagnosis.

关 键 词：特发性门脉高压 胰源性门脉高压 

分 类 号：R575.2[医药卫生—消化系统]