肝硬化门脉高压性胃病
Cirrhotic Portal Hypertension Gastropathy
摘要: 肝硬化门脉高压性胃病(Portal hypertension gastropathy, PHG)，主要发生在胃底、胃体部，是肝硬化常见并发症之一。其存在可影响消化吸收、导致慢性贫血以及严重时大出血可危及生命。国内外对肝硬化门脉高压性胃病的研究较少，本文就PHG主要发病机制及诊断与治疗方面做一综述，旨在进一步完善对PHG的认识与诊治。
Abstract: Portal hypertension gastropathy (PHG), which mainly occurs in the fundus and body of the stomach, is one of the common complications of liver cirrhosis. Its existence can affect digestion and absorp-tion and lead to chronic anemia; in severe cases, massive hemorrhage can be life-threatening. There are few studies on portal hypertensive gastropathy due to liver cirrhosis at home and abroad. This article reviews the main pathogenesis, diagnosis and treatment of PHG in order to further improve the understanding, diagnosis and treatment of PHG.
文章引用：陈思荣, 韩文, 郭晓娜. 肝硬化门脉高压性胃病[J]. 临床医学进展, 2023, 13(2): 2600-2607. https://doi.org/10.12677/ACM.2023.132368

参考文献

[1] Fontana, R.J., et al. (2006) Portal Hypertensive Gastropathy in Chronic Hepatitis C Patients with Bridging Fibrosis and Compensated Cirrhosis: Results from the HALT-C Trial. American Journal of Gastroenterology, 101, 983-992. [Google Scholar] [CrossRef] [PubMed]
[2] 王文生, 陈东风, 文良志. 门脉高压性胃病临床研究进展[J]. 实用肝脏病杂志, 2019, 22(4): 601-604.
[3] 朱峰. 门脉高压性胃肠病的新观点[J]. 中华内科杂志, 2012, 51(6): 427-428.
[4] Ohta, M., et al. (1994) Portal and Gastric Mucosal Hemodynamics in Cirrhotic Patients with Por-tal-Hypertensive Gastropathy. Hepatology, 20, 1432-1436. [Google Scholar] [CrossRef] [PubMed]
[5] Yi, Z., et al. (2021) Role of the Posterior Mucosal Defense Barrier in Portal Hypertensive Gastropathy. Biomedicine & Pharma-cotherapy, 144, Article ID: 112258. [Google Scholar] [CrossRef] [PubMed]
[6] Kai, S., et al. (2006) Ex-pression of Endothelin Receptors in the Gastric Mucosa of Portal Hypertensive Rats. Journal of Gastroenterology and Hepatology, 21, 242-250. [Google Scholar] [CrossRef] [PubMed]
[7] Foster, P.N., Wyatt, J.I., Bullimore, D.W., Losowsky, M.S. (1989) Gastric Mucosa in Patients with Portal Hypertension: Prevalence of Capillary Dilatation and Campylobacter Pylori. Journal of Clinical Pathology, 42, 919-921. [Google Scholar] [CrossRef] [PubMed]
[8] 杜建新, 蒋锦华, 孔严. 193例肝源性胃病与幽门螺杆菌的关系分析[J]. 中国医药指南, 2005(4): 44-45.
[9] 刘光伟, 赵文霞, 桂松林. 肝硬化门静脉高压性胃病患者出血风险与幽门螺杆菌感染的相关性研究[J]. 中国全科医学, 2016, 19(S1): 4-5.
[10] 刘伟, 潘晓林, 张国新. 幽门螺杆菌感染引起高胃泌素血症机制的研究进展[J]. 国际消化病杂志, 2013, 33(3): 169-171.
[11] 吴杰芳, 胥莹, 孟淑慧. 幽门螺杆菌感染与肝硬化并发症的关系研究[J]. 临床医学研究与实践, 2021, 6(7): 193-195.
[12] 陈朝元, 何顺勇, 高全达, 张传眺. 肝硬化门脉高压性胃病与幽门螺杆菌感染的相关性研究[J]. 实用肝脏病杂志, 2007, 10(4): 261-263.
[13] 潘永峰, 刘桂雪. 幽门螺杆菌感染与肝硬化门脉高压性胃病的相关性[J]. 中原医刊, 2003, 30(9): 17-18.
[14] Groszmann, R.J. and Wongcharatrawee, S. (2004) The Hepatic Venous Pressure Gradient: Anything Worth Doing Should Be Done Right. Hepatology, 39, 280-283. [Google Scholar] [CrossRef] [PubMed]
[15] Niederberger, M., et al. (1996) Comparison of Vascular Nitric Oxide Production and Systemic Hemodynamics in Cirrhosis versus Prehe-patic Portal Hypertension in Rats. Hepatology, 24, 947-951. [Google Scholar] [CrossRef] [PubMed]
[16] 李席如, 吴金生, 何泽生. 门脉高压症高动力循环产生机理[J]. 临床肝胆病杂志, 1998, 14(1): 13-15.
[17] 郭春梅, 吴静, 刘揆亮, 王亚丹. 瞬时弹性成像技术对肝硬化食管静脉曲张的预测价值及其与肝功能分级的相关性[J]. 胃肠病学和肝病学杂志, 2016, 25(3): 314-317.
[18] 霍宏蕾, 等. 肝硬化门脉高压性胃病临床分析[J]. 北京医学, 2012, 34(3): 219-220.
[19] 凌成军, 刘红星, 宋淑俊. 探讨肝硬化患者门脉高压性胃病的临床特点及其与肝功能分级、食管静脉曲张的关系[J]. 世界最新医学信息文摘, 2016, 16(97): 69+71.
[20] 陈国忠, 等. 门脉高压性胃病与食管静脉曲张、肝功能及幽门螺杆菌感染的关系[J]. 临床荟萃, 2005(12): 686-687.
[21] Calès, P., et al. (1990) Gastroesophageal Endoscopic Features in Cirrhosis. Observer Var-iability, Interassociations, and Relationship to Hepatic Dysfunction. Gastroenterology, 98, 156-162. [Google Scholar] [CrossRef] 
[22] Gupta, R., et al. (1998) Gastric Mucosal Blood Flow and He-patic Perfusion Index in Patients with Portal Hypertensive Gastropathy. Journal of Gastroenterology and Hepatology, 13, 921-926. [Google Scholar] [CrossRef] [PubMed]
[23] 王宇, 欧晓娟, 贾继东. 高动力循环在肝硬化疾病进展中的重要性及其治疗策略[J]. 中华肝脏病杂志, 2017, 25(7): 544-547.
[24] 姚国和, 杨冬华. 一氧化氮与门脉高压性胃病[J]. 国外医学(内科学分册), 2000(7): 305-308.
[25] Tsugawa, K., et al. (2000) Role of Vascular Endothe-lial Growth Factor in Portal Hypertensive Gastropathy. Digestion, 61, 98-106. [Google Scholar] [CrossRef] [PubMed]
[26] 赵永忠, 等. 血管内皮生长因子在大鼠门脉高压性胃病发病机制中的作用[J]. 华中科技大学学报(医学版), 2003, 32(2): 163-165+170.
[27] 史萍, 李静, 王姜琳. 慢性萎缩性胃炎患者血清胃蛋白酶原、胃泌素17水平的变化及其临床意义[J]. 中国实用医药, 2021, 16(33): 95-97.
[28] 张芙蓉, 宋丽, 韦兴静. 肝硬化患者血清胃蛋白酶原水平与肝硬化门脉高压胃病严重程度相关性分析[J]. 山西医药杂志, 2019, 48(4): 423-425.
[29] 黎杨杨, 林裕锋, 陈冬玲. 肝硬化门脉高压性胃病血清胃蛋白酶原的变化和意义分析[J]. 中外医学研究, 2020, 18(20): 50-52.
[30] 詹海勇, 等. 门脉高压性胃病患者血浆胃泌素、胃动素水平变化及意义[J]. 医学临床研究, 2006, 23(4): 491-493.
[31] 董蕾, 等. 幽门螺杆菌、肝功及食管曲张静脉套扎治疗对肝硬化门脉高压性胃病的影响[J]. 西安交通大学学报(医学版), 2002, 23(6): 595-597.
[32] Ferraioli, G., et al. (2018) Liver Ultra-sound Elastography: An Update to the World Federation for Ultrasound in Medicine and Biology Guidelines and Rec-ommendations. Ultrasound in Medicine and Biology, 44, 2419-2440. [Google Scholar] [CrossRef] [PubMed]
[33] Parker, K.J., Doyley, M.M. and Rubens, D.J. (2011) Im-aging the Elastic Properties of tissue: The 20 Year Perspective. Physics in Medicine & Biology, 56, R1-R29. [Google Scholar] [CrossRef] 
[34] Ophir, J., Céspedes, I., Ponnekanti, H., Yazdi, Y. and Li, X. (1991) Elastography: A Quantitative Method for Imaging the Elasticity of Biological Tissues. Ultrasonic Imaging, 13, 111-134. [Google Scholar] [CrossRef] [PubMed]
[35] Marginean, C.O. and Marginean, C. (2012) Elasto-graphic Assessment of Liver Fibrosis in Children: A Prospective Single Center Experience. European Journal of Radi-ology, 81, e870-e874. [Google Scholar] [CrossRef] [PubMed]
[36] Sporea, I., et al. (2011) Is It Better to Use Two Elastographic Methods for Liver Fibrosis Assessment? World Journal of Gastroenterology, 17, 3824-3829. [Google Scholar] [CrossRef] [PubMed]
[37] Yoon, K.T., et al. (2012) Liver Stiffness Measurement Using Acoustic Radiation Force Impulse (ARFI) Elastography and Effect of Necroinflammation. Digestive Diseases and Sci-ences, 57, 1682-1691. [Google Scholar] [CrossRef] [PubMed]
[38] Fraquelli, M., et al. (2011) Etiology-Related Determinants of Liver Stiffness Values in Chronic Viral Hepatitis B or C. Journal of Hepatology, 54, 621-628. [Google Scholar] [CrossRef] [PubMed]
[39] Janik, M.K., et al. (2021) Measurement of Liver and Spleen Stiff-ness as Complementary Methods for Assessment of Liver Fibrosis in Autoimmune Hepatitis. Liver International, 41, 348-356. [Google Scholar] [CrossRef] [PubMed]
[40] 王云溪, 毛建娜, 歧红阳. 肝硬化门脉高压性胃病与幽门螺杆菌感染关系探讨[J]. 职业与健康, 2010, 26(13): 1546-1547.
[41] Garg, H., Gupta, S., Anand, A.C. and Broor, S.L. (2015) Portal Hypertensive Gastropathy and Gastric Antral Vascular Ectasia. Indian Journal of Gastroenterology, 34, 351-358. [Google Scholar] [CrossRef] [PubMed]
[42] Merli, M., et al. (2004) The Natural History of Portal Hypertensive Gastropathy in Patients with Liver Cirrhosis and Mild Portal Hypertension. American Journal of Gastro-enterology, 99, 1959-1965. [Google Scholar] [CrossRef] [PubMed]

为你推荐