Kovaleva O I, Khomeriki S G, Zhukov A G, Koviazina I O, Golovanova E V
Eksp Klin Gastroenterol. 2010(2):13-8.
Prominent mucosal vasodilatation mediated by increased production of nitric oxide is thought to be manifestation of portal hypertensive gastropathy (PHG) in patients with chronic diffuse liver diseases. Recently was shown that Helicobacter pylori (Hp) infection could stimulate nitric oxide activity.
To investigate if chronic Hp infection is involved in development of gastric mucosal capillary dilatation in patients with PHG.
The study was performed on 56 patients with PHG evaluated by upper endoscopy. The gastric biopsy was obtained from antrum and corpus. Hp status was assessed by rapid urease test and histology. Gastric mucosal capillary network (GMCN) assessed on histological sections immunostained for CD34, specific marker for endothelial cells. Nikon-CP995 camera and digital image analyzing system (DMI-1) was used for morphometry.
Marked vasodilatation was observed in antrum mucosa of Hp- patients with PHG and Hp+ patients without PHG (p < 0.05), relative volume of vessels was also increased, but number of vessels was not changed significantly. The relative volume and number of vessels in corpus mucosa were significantly higher in Hp- with PHG and Hp+ without PHG (p < 0.01). The mean size of vessels in corpus mucosa was decreased in Hp- with PHG (p < 0.05), but was not changed in Hp+ patients. Morphometric parameters in Hp+ with PHG was not changed significantly as compared to Hp+ without PHG or Hp- patients.
Hp provokes the same morphometric changes in GMCN as PHG. Hp may be one of factors important for regulation of GMCN function and structure. No additive effect between Hp infection and PHG on GMCN was observed in patients with PHG.
一氧化氮生成增加介导的显著黏膜血管扩张被认为是慢性弥漫性肝病患者门脉高压性胃病（PHG）的表现。最近研究表明幽门螺杆菌（Hp）感染可刺激一氧化氮活性。
研究慢性Hp感染是否参与PHG患者胃黏膜毛细血管扩张的发生。
对56例经上消化道内镜检查评估的PHG患者进行研究。取自胃窦和胃体的胃活检组织。通过快速尿素酶试验和组织学评估Hp感染状态。在对内皮细胞特异性标志物CD34进行免疫染色的组织切片上评估胃黏膜毛细血管网络（GMCN）。使用尼康CP995相机和数字图像分析系统（DMI-1）进行形态测量。
在PHG的Hp阴性患者和无PHG的Hp阳性患者的胃窦黏膜中观察到明显的血管扩张（p<0.05），血管相对容积也增加，但血管数量无明显变化。PHG的Hp阴性患者和无PHG的Hp阳性患者胃体黏膜中血管的相对容积和数量显著更高（p<0.01）。PHG的Hp阴性患者胃体黏膜中血管的平均大小减小（p<0.05），但Hp阳性患者中无变化。与无PHG的Hp阳性患者或Hp阴性患者相比，PHG的Hp阳性患者的形态测量参数无明显变化。
Hp引起的GMCN形态测量变化与PHG相同。Hp可能是调节GMCN功能和结构的重要因素之一。在PHG患者中未观察到Hp感染和PHG对GMCN的叠加效应。
