Iijima J, Matsutani S, Saisho H, Ohto M
First Department of Medicine, School of Medicine, Chiba University.
Nihon Shokakibyo Gakkai Zasshi. 1994 Oct;91(10):1929-35.
The clinicopathological characteristics of the diffuse gastric mucosal redness were studied in 235 patients with liver cirrhosis. Moreover, in 96 patients in whom percutaneous transhepatic portal catheterization was carried out, the relationship was studied between gastric mucosal lesions and portal hemodynamic aspect with reference to portal vein pressure and extrahepatic collaterals. Extrahepatic collaterals were divided into three groups, which related either of cephalad, caudal and peri-abdominal as the most prevalent extrahepatic collateral on portographic findings. The frequency of the diffuse gastric mucosal redness was increased with the elevation of portal vein pressure, and it was seen more frequently in patients with cephalad collaterals than in caudal. However, the diffuse gastric mucosal redness was seen less frequently in patients with cephalad collateral accompanied with the development of renal shunts. Multiple logistic model analysis showed significant correlation between the diffuse gastric mucosal redness and the development of cephalad collaterals. These results suggest that the gastric mucosal circulation in liver cirrhosis is strongly affected by the development of portosystemic collaterals in portal hypertension.
对235例肝硬化患者弥漫性胃黏膜发红的临床病理特征进行了研究。此外，对96例行经皮经肝门静脉置管术的患者，参照门静脉压力和肝外分流情况，研究胃黏膜病变与门静脉血流动力学之间的关系。肝外分流分为三组，根据门静脉造影结果，分别以头侧、尾侧和腹部周围分流作为最常见的肝外分流。弥漫性胃黏膜发红的发生率随门静脉压力升高而增加，头侧分流患者比尾侧分流患者更常见。然而，伴有肾分流形成的头侧分流患者弥漫性胃黏膜发红较少见。多因素逻辑回归模型分析显示弥漫性胃黏膜发红与头侧分流的形成之间存在显著相关性。这些结果表明，肝硬化患者的胃黏膜循环受门静脉高压时门体分流形成的强烈影响。
