肝硬化患者门静脉高压性肠病加重的预测因素：胶囊内镜研究。

Predictive Factors of Portal Hypertensive Enteropathy Exacerbation in Patients with Liver Cirrhosis: A Capsule Endoscopy Study.

机构信息

Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.

Department of Endoscopy and Medicine, Hiroshima University Hospital, Hiroshima, Japan.

出版信息

Digestion. 2018;98(1):33-40. doi: 10.1159/000486666. Epub 2018 Apr 19.

DOI:10.1159/000486666

PMID:29672296

Abstract

BACKGROUND/AIMS: The clinical course and exacerbation of portal hypertensive enteropathy (PHE) are yet to be fully clarified. This study aimed to identify factors related to PHE exacerbation in patients with liver cirrhosis (LC).

METHODS

Fifty patients with LC (33 male; mean age, 67 years), who underwent capsule endoscopy (CE) at the Hiroshima University Hospital between February 2009 and September 2015, were followed up for >6 months. Exacerbation is defined as the appearance of new lesions or worsening of existing lesions. The association between PHE exacerbation and the clinical factors was evaluated.

RESULTS

PHE exacerbation was identified in 24 out of 50 (48%) of cases: erythema (14 cases); angioectasia (11 cases); erosions (9 cases); villous edema (8 cases); and esophageal varices (EVs; 6 cases). The following factors were significantly associated with PHE exacerbation: portosystemic shunts, EVs and portal hypertensive gastropathy (PHG) exacerbation. After therapy, CE findings among the 24 cases were as follows: villous edema (19 cases); erythema (17 cases); angioectasia (16 cases); erosions (12 cases); and EVs (9 cases), and no observable abnormalities in 2 cases. On multivariate analysis, exacerbation of EVs and PHG were independent predictors of PHE exacerbation.

CONCLUSION

EVs and PHG exacerbation may predict PHE exacerbation in patients with LC.

摘要

背景/目的：门静脉高压性肠病（PHE）的临床病程和恶化仍未完全阐明。本研究旨在确定与肝硬化（LC）患者 PHE 恶化相关的因素。

方法

2009 年 2 月至 2015 年 9 月，在广岛大学医院进行胶囊内镜（CE）检查的 50 例 LC 患者（33 名男性；平均年龄 67 岁）接受了随访>6 个月。恶化定义为新病变的出现或现有病变的恶化。评估了 PHE 恶化与临床因素之间的关系。

结果

50 例中有 24 例（48%）出现 PHE 恶化：红斑（14 例）；血管扩张（11 例）；糜烂（9 例）；绒毛水肿（8 例）；食管静脉曲张（EVs；6 例）。以下因素与 PHE 恶化显著相关：门体分流、EVs 和门静脉高压性胃病（PHG）恶化。经过治疗，24 例的 CE 结果如下：绒毛水肿（19 例）；红斑（17 例）；血管扩张（16 例）；糜烂（12 例）；EVs（9 例），2 例无明显异常。多变量分析显示，EVs 和 PHG 恶化是 PHE 恶化的独立预测因素。