Department of Internal Medicine and Institute of Basic Medical Science, Yonsei University, Wonju College of Medicine, Wonju, South Korea.
Dig Dis Sci. 2010 Dec;55(12):3561-7. doi: 10.1007/s10620-010-1221-6. Epub 2010 Apr 21.
Portal hypertensive gastropathy (PHG) is a common endoscopic finding in patients with cirrhosis. However, the relationship between PHG and portal hypertension is controversial. Furthermore, nothing is known regarding the correlation between PHG and prognosis in patients with cirrhosis.
The hepatic venous pressure gradient (HVPG), endoscopic PHG grade, Child-Pugh score, and model for end-stage liver disease (MELD) score were assessed at baseline and were followed prospectively in 331 cirrhotic patients (284 males, 85.8%; mean age, 52.16 ± 9.05 years) from January 2001 to April 2009. The relationship between PHG with HVPG and survival was investigated.
The HVPG was significantly higher in patients with severe PHG than in those with mild or no PHG (absent, 4.9 ± 1.7 mmHg; mild, 10.7 ± 4.1 mmHg; severe, 15.6 ± 4.6 mmHg; P < 0.001). During follow-up, 28 patients (8.5%) died from liver-related disease. In the Cox regression analysis, severe PHG (none and mild vs. severe) (hazard ratio 1.153, 95% confidence interval: 1.048-1.269) showed a significantly high relative risk of mortality, and in the Kaplan-Meier analysis, severe PHG showed a significantly shorter expected survival time than none or mild PHG (median survival time, 77.6 ± 9.6 months in severe PHG; log-rank test, P = 0.030).
PHG was associated with portal hypertension severity and prognosis in patients with cirrhosis.
门脉高压性胃病（PHG）是肝硬化患者常见的内镜表现。然而，PHG 与门脉高压之间的关系存在争议。此外，对于肝硬化患者中 PHG 与预后之间的相关性尚不清楚。
在 2001 年 1 月至 2009 年 4 月期间，对 331 例肝硬化患者（284 名男性，85.8%；平均年龄 52.16 ± 9.05 岁）进行了肝静脉压力梯度（HVPG）、内镜 PHG 分级、Child-Pugh 评分和终末期肝病模型（MELD）评分的基线评估，并进行了前瞻性随访。研究了 PHG 与 HVPG 和生存率之间的关系。
严重 PHG 患者的 HVPG 明显高于轻度或无 PHG 患者（无 PHG，4.9 ± 1.7mmHg；轻度 PHG，10.7 ± 4.1mmHg；严重 PHG，15.6 ± 4.6mmHg；P<0.001）。在随访期间，28 例患者（8.5%）死于与肝脏相关的疾病。在 Cox 回归分析中，严重 PHG（无和轻度与严重）（风险比 1.153，95%置信区间：1.048-1.269）显示出较高的死亡相对风险，在 Kaplan-Meier 分析中，严重 PHG 显示出比无或轻度 PHG 更短的预期生存时间（严重 PHG 的中位生存时间为 77.6 ± 9.6 个月；对数秩检验，P=0.030）。
PHG 与肝硬化患者的门静脉高压严重程度和预后相关。
