Saeki Michio, Okubo Hironao, Takasaki Yusuke, Nakadera Eisuke, Fukuo Yuka, Fukada Hiroo, Hotchi Yuta, Maruyama Hitoshi, Kokubu Shigehiro, Shiina Shuichiro, Nagahara Akihito, Ikejima Kenichi
Department of Gastroenterology, Juntendo University Nerima Hospital, Tokyo 177-8521, Japan.
Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan.
J Clin Med. 2023 Apr 3;12(7):2662. doi: 10.3390/jcm12072662.
This study investigated the impact of partial splenic embolization (PSE) on portal hypertensive gastropathy (PHG). We retrospectively analyzed endoscopic findings and the portal venous system of 31 cirrhotic patients with PHG. The improved group was defined as the amelioration of PHG findings using the McCormack classification. Child-Pugh scores of the improved group (18 of 31 patients) were significantly lower compared with those of the non-improved group ( = 0.018). The changes in the diameters of the portal trunk and those of the spleno-portal junction and spleen hilum in the splenic vein of the improved group were significantly larger than those of the non-improved group ( = 0.007, = 0.025, and = 0.003, respectively). The changes in the diameters of the portal vein and splenic hilum of the splenic vein showed significant correlations with Child-Pugh score (r = 0.386, = 0.039; r = 0.510, = 0.004). In a multivariate analysis of baseline factors related to the improved group, Child-Pugh grade A was significantly associated with the improvement of PHG (odds ratio 6.875, = 0.033). PSE could be useful for PHG, especially in patients with Child-Pugh grade A, at least in the short term.
本研究调查了部分脾栓塞术（PSE）对门静脉高压性胃病（PHG）的影响。我们回顾性分析了31例患有PHG的肝硬化患者的内镜检查结果和门静脉系统。改善组定义为使用麦科马克分类法使PHG表现得到改善的患者。改善组（31例患者中的18例）的Child-Pugh评分显著低于未改善组（P = 0.018）。改善组门静脉主干、脾门静脉交界处和脾静脉脾门处直径的变化显著大于未改善组（分别为P = 0.007、P = 0.025和P = 0.003）。脾静脉门静脉和脾门处直径的变化与Child-Pugh评分显著相关（r = 0.386，P = 0.039；r = 0.510，P = 0.004）。在对与改善组相关的基线因素进行多因素分析时，Child-Pugh A级与PHG的改善显著相关（比值比6.875，P = 0.033）。PSE可能对PHG有用，尤其是对Child-Pugh A级患者，至少在短期内如此。
