Chen L S, Lin H C, Lee F Y, Hou M C, Lee S D
Dept. of Medicine, Veterans General Hospital, Taipei, Taiwan.
Scand J Gastroenterol. 1996 May;31(5):490-4. doi: 10.3109/00365529609006770.
Colonic vascular ectasias and colorectal varices have been observed in patients with cirrhosis. However, the pathogenesis of these vascular lesions has not been established.
We enrolled 35 cirrhotic patients and 20 normal controls in this study. All received colonoscopic examinations and measurements of plasma glucagon levels. Portal pressure measurements were performed in all the cirrhotic patients.
Colonic vascular ectasias occurred more commonly in cirrhotic patients than in controls (17 of 35 versus 0 of 20; p = 0.009) and more commonly in cirrhotic patients with ascites than in those without (15 of 24 versus 2 of 11; p = 0.038). However, the presence of colonic vascular ectasias was not related to the hepatic venous pressure gradient or plasma glucagon levels. Colorectal varices also occurred more commonly in cirrhotic patients than in controls (16 of 35 versus of 1 of 20; p = 0.034), but the hepatic venous pressure gradient, plasma glucagon levels, and severity of cirrhosis were not related to the presence of colorectal varices.
Portal hypertension per se and increased plasma glucagon levels may not play an important role in the pathogenesis of colonic vascular ectasias or colorectal varices in patients with cirrhosis.
在肝硬化患者中已观察到结肠血管扩张和结肠直肠静脉曲张。然而，这些血管病变的发病机制尚未明确。
本研究纳入了35例肝硬化患者和20例正常对照。所有人均接受了结肠镜检查及血浆胰高血糖素水平测定。对所有肝硬化患者进行了门静脉压力测量。
结肠血管扩张在肝硬化患者中比在对照组中更常见（35例中的17例 vs 20例中的0例；p = 0.009），并且在有腹水的肝硬化患者中比在无腹水的患者中更常见（24例中的15例 vs 11例中的2例；p = 0.038）。然而，结肠血管扩张的存在与肝静脉压力梯度或血浆胰高血糖素水平无关。结肠直肠静脉曲张在肝硬化患者中也比在对照组中更常见（35例中的16例 vs 20例中的1例；p = 0.034），但肝静脉压力梯度、血浆胰高血糖素水平及肝硬化的严重程度与结肠直肠静脉曲张的存在无关。
门静脉高压本身及血浆胰高血糖素水平升高在肝硬化患者结肠血管扩张或结肠直肠静脉曲张的发病机制中可能不发挥重要作用。
