Yamakado S, Kanazawa H, Kobayashi M
Third Department of Internal Medicine, Nippon Medical School, Tokyo.
Intern Med. 1995 Mar;34(3):153-7. doi: 10.2169/internalmedicine.34.153.
Portal hypertensive colopathy (PHC) is a new clinical entity in patients with liver cirrhosis. In this study, colonoscopic findings and clinical features including upper gastrointestinal endoscopy and hepatic hemodynamics were prospectively investigated among 35 PH patients with a hepatic venous pressure gradient (HVPG) of greater than 12 mmHg due to chronic liver diseases. Colonoscopy was also performed in 100 patients without liver disease as non-PH controls. The colonoscopy revealed vascular ectasias, vascular irregularity, vascular dilatation, solitary red spots, diffuse red spots, and hemorrhoids in 26, 32, 30, 25, 10 and 25, respectively, of 35 PH patients compared to 3, 7, 3, 11, 0 and 19, respectively, in controls. PHC was endoscopically diagnosed in 27 of 35 PH patients according to our criteria. These patients with PHC were more frequently associated with esophageal varices and portal hypertensive gastropathy, and had higher HVPG than PH patients without PHC. Portal hypertension is an important factor in the etiology of PHC.
门静脉高压性结肠病（PHC）是肝硬化患者中的一种新的临床实体。在本研究中，对35例因慢性肝病导致肝静脉压力梯度（HVPG）大于12 mmHg的门静脉高压（PH）患者，前瞻性地研究了结肠镜检查结果以及包括上消化道内镜检查和肝脏血流动力学在内的临床特征。还对100例无肝病患者进行了结肠镜检查作为非PH对照组。结肠镜检查显示，35例PH患者中分别有26例、32例、30例、25例、10例和25例出现血管扩张、血管不规则、血管扩张、孤立性红点、弥漫性红点和痔疮，而对照组分别为3例、7例、3例、11例、0例和19例。根据我们的标准，35例PH患者中有27例经内镜诊断为PHC。这些PHC患者更常伴有食管静脉曲张和门静脉高压性胃病，且其HVPG高于无PHC的PH患者。门静脉高压是PHC病因中的一个重要因素。
