放大内镜窄带成像技术对门脉高压胃黏膜微细结构的观察

目的应用放大内镜窄带成像技术（NBI-ME）观察乙肝肝硬化伴门脉高压症胃黏膜病变的微细结构的特点。 方法收集2009年1月至5月来我院就诊的患者，经临床、实验室检查确诊为乙肝肝硬化伴门脉高压的患者64名（PHT组），设置47名慢性胃炎患者为对照组，对两组胃黏膜微细结构进行比较。 结果PHT组胃黏膜分型以Z1型（51．6％）、Z2型（31．3％）为主。Z3型发生率PHT组与CSG组比较差别无统计学意义（6．3％vs6.4％，P〉0．05）。PHT组集合静脉分型，以I型（46．9％）、D型（37．5％）为主。R型发生率PTH组明显低于CSG组（10．9％vs51．1％。P〈0．001）；I型（46．9％VS31．9％，P〉0．05）、L型（4．7％vs4．3％，P〉0．05）在两组间差异无统计学意义。结论胃黏膜分型、集合静脉分型可以反映门脉高压症组胃黏膜病变的严重程度。

The Feature of The Portal Hypertensive Gastric Mucosa on Narrow Band-imaging with Magnifying Endoscopy

Objective： To observe the characterization of endoscopic features of the gastric mucosa in PHT by magnifying endoscopy with narrow band-imaging.
Methods： 64 patients with portal hypertension （PHT） were colleted to observe under narrow band-imaging with magnifying endoscopy （NBI-ME）. The results were compared with that of the gastric mueosa in 47 patients with chronic superficial gastritis （CSG）.
Results： Among the gastric mucosa types, the PHT group has lower incidence than the CSG group in Z0 type （10.9% vs. 68.1%, P〈0.001）, but Z1 type （31.3% vs. 8.5%, P〈0.001）, Z2 type （31.3% vs. 8.5%, P〈0.001） were more frequently in group 1 than group 2. Z3 type （6.3% vs. 6.4%, P〉0.05） had no significant difference between the two groups. Among the types of collecting venules, the PHT Group has lower incidence with the CSG group in Regular type（R type） collecting venules （10.9% vs. 51.1%, P〈0.001）, irregular type （I type） （46.9% vs. 31.9%,P〉0.05）, Large and dilated type （L type） （4.7% vs. 4.3%,P〉〉0.05） had no statistic difference between the two groups. Disappeared type （D type） had more frequency in group 1 than group 2 （37.5% vs. 12.8%, P〈0.01）. Conclusions： Types of the gastric mucosa and collecting venules can reflect the severity of the gastric mueosa lesions in Portal hypertension.