Sawant P, Bhatia R, Kulhalli P M, Mahajani S S, Nanivadekar S A
Department of Gastroenterology, Lokmanya Tilak Municipal Medical College & Hospital, Sion, Bombay.
Indian J Gastroenterol. 1995 Jul;14(3):87-90.
To compare gastric mucosal blood flow (GMBF) in normal subjects with that in patients with portal hypertension with or without portal hypertensive gastropathy (PHG).
GMBF was measured by endoscopic laser-Doppler velocimetry in 20 gastroscopically normal subjects and 30 patients with portal hypertension with or without PHG. The effects of breath-holding (vasomotor reflex), submucosal epinephrine and sublingual isosorbide dinitrate were also studied.
In normal subjects, GMBF on the greater curvature was (mean +/- SD) 9.5 +/- 1.3 V and on the lesser curvature, 9.1 +/- 1.9 V. Breath-holding caused a reduction in GMBF by 57.1 +/- 13.7%, submucosal epinephrine reduced it by 41.5 +/- 21.5% and sublingual isosorbide caused a rise of 25.8 +/- 15.2%. The GMBF on the greater and lesser curvature respectively in patients with mild PHG (7.7 +/- 1.2 V and 7.7 +/- 0.8 V) and those with severe PHG (6.5 +/- 3.5 V and 6.3 +/- 2.2 V), was significantly less than that in normal subjects (p < 0.05 and p < 0.001 respectively). Vasomotor reflex was blunted in patients with mild and severe PHG (23.3% +/- 20.3 and 23.1% +/- 17.7 respectively, p < 0.001). Responses to submucosal epinephrine and sublingual isosorbide were similar to those recorded in normal subjects.
Patients with portal hypertension have significantly reduced GMBF and significantly attenuated vasomotor reflex in the gastric vascular bed as compared to normal subjects.
比较正常受试者与伴有或不伴有门静脉高压性胃病（PHG）的门静脉高压患者的胃黏膜血流（GMBF）。
采用内镜激光多普勒测速仪测量20例胃镜检查正常的受试者以及30例伴有或不伴有PHG的门静脉高压患者的GMBF。还研究了屏气（血管运动反射）、黏膜下注射肾上腺素和舌下含服硝酸异山梨酯的影响。
正常受试者中，胃大弯处的GMBF为（均值±标准差）9.5±1.3V，胃小弯处为9.1±1.9V。屏气使GMBF降低57.1±13.7%，黏膜下注射肾上腺素使其降低41.5±21.5%，舌下含服硝酸异山梨酯使其升高25.8±15.2%。轻度PHG患者胃大弯和胃小弯处的GMBF分别为（7.7±1.2V和7.7±0.8V），重度PHG患者分别为（6.5±3.5V和6.3±2.2V），均显著低于正常受试者（分别为p<0.05和p<0.001）。轻度和重度PHG患者的血管运动反射均减弱（分别为23.3%±20.3和23.1%±17.7，p<0.001）。对黏膜下注射肾上腺素和舌下含服硝酸异山梨酯的反应与正常受试者相似。
与正常受试者相比，门静脉高压患者的GMBF显著降低，胃血管床的血管运动反射显著减弱。
