Voulgaris Theodoros, Karagiannakis Dimitrios, Siakavellas Spyridon, Kalogera Despina, Angelopoulos Theodoros, Chloupi Elissavet, Karamanolis George, Papatheodoridis George, Vlachogiannakos John
Academic Department of Gastroenterology and Hepatology, LAIKO General Hospital, University of Athens, Medical School, Athens, Greece.
Ann Gastroenterol. 2019 Sep-Oct;32(5):451-456. doi: 10.20524/aog.2019.0399. Epub 2019 Jul 6.
Peptic ulcer disease (PUD) is more prevalent in cirrhotics and this may aggravate prognosis. We investigated the prevalence of PUD in cirrhotics and its potential association with () infection, the underlying etiology and severity of liver disease, and other manifestations of portal hypertension (PH).
We enrolled consecutive asymptomatic cirrhotic patients who underwent screening endoscopy in a tertiary hospital during a 12-month period. We recorded the presence of PUD and the endoscopic findings associated with PH. infection was documented through either histology or CLO-test. The diagnosis of cirrhosis was based on elastography, liver biopsy or a combination of clinical, biochemical and imaging data.
One hundred patients (M/F: 54/46, mean age: 61±14 years) were included in the analysis. Viral hepatitis (37%) and alcohol (22%) were the most common causes of cirrhosis. Child-Pugh stage was A/B/C: 60/35/5. PUD was found in 19 patients (14 gastric, 5 duodenal). infection was diagnosed in 54%. Varices were detected in 59% (39% needed treatment). PH gastropathy was present in 81% (severe in 33%). The presence of PUD was unrelated to the etiology and the severity of liver disease or to other endoscopic manifestations of PH. No correlation was found between PUD and infection.
A high prevalence of PUD was observed in our cirrhotic patients, although they were asymptomatic and had no known risk factors of ulcerogenicity. The value of screening endoscopy for the early diagnosis and treatment of PUD in cirrhotics deserves further investigation.
消化性溃疡病（PUD）在肝硬化患者中更为常见，这可能会加重预后。我们调查了肝硬化患者中PUD的患病率及其与（）感染、肝脏疾病的潜在病因和严重程度以及门静脉高压（PH）的其他表现之间的潜在关联。
我们纳入了在一家三级医院连续12个月接受筛查性内镜检查的无症状肝硬化患者。我们记录了PUD的存在情况以及与PH相关的内镜检查结果。通过组织学或CLO检测记录（）感染情况。肝硬化的诊断基于弹性成像、肝活检或临床、生化和影像学数据的综合判断。
100例患者（男/女：54/46，平均年龄：61±14岁）纳入分析。病毒性肝炎（37%）和酒精（22%）是肝硬化最常见的病因。Child-Pugh分级为A/B/C级：60/35/5。19例患者发现有PUD（14例为胃溃疡，5例为十二指肠溃疡）。54%的患者诊断有（）感染。59%的患者检测到静脉曲张（39%需要治疗）。81%的患者存在PH性胃病（33%为重度）。PUD的存在与肝脏疾病的病因和严重程度或PH的其他内镜表现无关。未发现PUD与（）感染之间存在相关性。
在我们的肝硬化患者中观察到PUD的高患病率，尽管他们无症状且无已知的致溃疡危险因素。筛查性内镜检查对肝硬化患者PUD的早期诊断和治疗的价值值得进一步研究。
