肝硬化患者胃黏膜前列腺素E2的研究

目的研究肝硬化患者胃黏膜前列腺素E2(PGE2)及意义。方法选取肝硬化患者60例及慢性胃炎、非溃疡性消化不良(NUD)患者各80例,行上消化道内镜检查,取胃窦及胃体各1块黏膜组织,用RIA法检测PGE2含量。结果(1)肝硬化组胃黏膜PGE2含量明显低于慢性胃炎及NUD组。(2)在肝硬化患者中,胃黏膜PGE2含量门脉高压胃病(PHG)组明显低于非PHG组,肝源性溃疡(HU)组亦明显低于非HU组,而与肝功能分级无关。结论(1)肝硬化胃黏膜防御机制减弱。(2)肝硬化胃黏膜PGE2的异常参与PHG及HU的形成。

The Study of Gastric Mucosal PGE2 in Patients with Liver Cirrhosis

Objective To investigate the gastric mucosal PGE2 in patients with liver cirrhosis and its clinical significance.Methods 60 patients with cirrhosis,80 patients with chronic gastritis(CG)and 80 patients with non-ulcer dyspepsia(NUD)were randomly involved in this study.The diagnosis of cirrhosis in every patient was confirmed by a combination of clinical,biochemical,imaging and endoscopic methods.The severity of cirrhosis was assessed by Pugh's modification of Child's criteria.All patients had undergone upper gastrointestinal endoscopy,performed with an Olympus EVIS 240.During endoscopic examination,one mucosal biopsy specimens from the gastric antrum and one from the gastric body were taken from every patient.The levels of PGE2 were measured with radioimmunoassay(RIA).Results(1)level of PGE2 in gastric mucosa in the patients with cirrhosis was much lower than that of the patients with CG or the patients with NUD.(2)The gastric mucosa levels of PGE2 in cirrhotics with portal hypertensive gastropathy(PHG)was significantly lower than that in cirrhotics without PHG,and that of patients with hepatogenic ulcer(HU)was much lower than that of the patients without HU.In addition,there was no significant relationship between the level of gastric mucosa PGE2 in cirrhotics and Child's classification.Conclusion(1)The gastric mucosal barrier in cirrhotics is more fragile.(2)The abnormal gastric mucosal PGE2 in cirrhotics plays an important role in the mechanism of PHG and HU.