特发性门脉高压症误诊为肝硬化临床分析  

Clinical analysis of 6 cases of idiopathic portal hypertension misdiagnosed as cirrhosis

作　　者：王曙照[1] 刘钊[2] 于红卫[2] 李娟[2] 孟庆华[2] 

机构地区：[1]首都医科大学附属北京佑安医院感染科,北京100069 [2]首都医科大学附属北京佑安医院重症肝病科,北京100069

出　　处：《中国误诊学杂志》2011年第29期7065-7066,共2页Chinese Journal of Misdiagnostics

摘　　要：目的探讨特发性门脉高压症(IPH)误诊为肝硬化。方法回顾性分析6例临床诊断为肝硬化而病理证实为IPH患者的临床及病理资料,并与10例病理证实为肝硬化的门脉高压患者进行对比研究。结果 IPH患者中5例胆碱酯酶(CHE)高于4 400 U/L,凝血酶原活动度(PTA)大于80%;IPH病理特点门静脉分支纤维化为主,均未见"假小叶"。结论 IPH患者影像学表现类似肝硬化;CHE 4400 U/L及PTA 80%可作为鉴别IPH与肝硬化的重要指标;病理排除肝硬化是IPH必要的诊断标准。Objective To investigate the reason why idiopathic portal hypertension（IPH） was misdiagnosed as cirrhosis with portal hypertension.Methods 6 cases of IPH were retrospectively analyzed,all of which were misdiagnosed clinically as cirrhosis with portal hypertension but confirmed as IPH by pathology.And comparatively study with 10 cases pathologically proven cirrhosis were also undergone.Results In 6 cases of IPH patients,CHE was above 4 400 U/L and PTA over 80% in 5 cases（5/6）;Pathological fidings showed no pseudolobules.Conclusion Imaging findings of IPH is similar with cirrhosis,but the degree of portal hypertension and pathologic damage are milder than patients with cirrhosis;CHE over 4 400 U/L and PTA over 80% can be used as differential indicators.Pathological detection is essential to exclude liver cirrhosis while diagnosing IPH.

关 键 词：高血压 门静脉/诊断 肝硬化/诊断 误诊 

分 类 号：R657.34[医药卫生—外科学]