Fujiwara Y, Arakawa T, Higuchi K, Kuroki T
3rd Department of Internal Medicine, Osaka City University Medical School.
Nihon Rinsho. 1998 Sep;56(9):2387-90.
The gastrointestinal bleeding commonly observed in patients with liver cirrhosis is usually from esophageal and gastric varices, gastroduodenal ulcer, and congestive gastropathy. Portal hypertension is the major causative factor of pathogenesis of GI lesions. In the present review, we focus in gastric mucosal defense and Helicobacter pylori infection in liver cirrhosis. Gastric mucosal defense is reduced in liver cirrhosis, especially prostaglandins which play a role in the gastric mucosal defense decreased in the gastric mucosal of patients with liver cirrhosis and rat portal hypertension model. Although H. pylori is strongly associated with peptic ulcer disease and chronic gastritis, several studies showed no relationship between H. pylori infection and gastroduodenal ulcer or the infection and congestive gastropathy in liver cirrhosis. Reduced gastric mucosal defense may account for the pathogenesis of GI lesions in liver cirrhosis.
肝硬化患者中常见的胃肠道出血通常源于食管和胃静脉曲张、胃十二指肠溃疡以及充血性胃病。门静脉高压是胃肠道病变发病机制的主要致病因素。在本综述中，我们聚焦于肝硬化患者的胃黏膜防御和幽门螺杆菌感染。肝硬化患者的胃黏膜防御功能降低，尤其是在胃黏膜防御中起作用的前列腺素，在肝硬化患者的胃黏膜以及大鼠门静脉高压模型中均有所减少。尽管幽门螺杆菌与消化性溃疡病和慢性胃炎密切相关，但多项研究表明，幽门螺杆菌感染与肝硬化患者的胃十二指肠溃疡或感染与充血性胃病之间并无关联。胃黏膜防御功能降低可能是肝硬化患者胃肠道病变发病机制的原因。
