慢性重型肝炎伴门静脉高压性胃病及急性胃黏膜病变的研究

目的观察慢性重型肝炎患者合并胃黏膜病变的特点。方法521例研究对象共分为3组:A组191例,为肝硬化基础上的慢性重型肝炎住院患者;B组175例,为慢性肝炎基础上的慢性重型肝炎住院患者;C组155例,为对照组,既往无慢性肝病史的急性黄疸性肝炎住院患者。所有研究对象于入院后3 d内行胃镜检查,观察门静脉高压性胃病(PHG)及急性胃黏膜病变(AGML)的检出情况。结果A组患者有131例(68.6%)检出PHG,81例(42.4%)检出AGML,B组患者PHG和AGML检出例数分别为119例(68.0%)和79例(45.1%),C组PHG和AGML的检出例数分别为11例(7.0%)和21例(13.5%);A组与B组患者其PHG及AGML检出例数之间的差异均无统计学意义(P>0.05),但无论A组或是B组其PHG及AGML检出例数与C组相比,差异均有统计学意义(P<0.05)。结论慢性肝炎或肝硬化基础上的慢性重型肝炎患者易合并PHG及AGML,上述2种胃黏膜病变的胃镜检出率远高于急性黄疸性肝炎患者。PHG及AGML可能与慢性肝病基础有关。

Study of Acute Gastric Mucosal Lesion and Portalvein Hypertensive Gastropathy Complication in Patients with Severe-type Hepatitis

Objective To investigate the features of the acute gastric mucosal lesion in patients with chronic severe-type hepatitis by endoscopy.Methods 521 patients were divided into three groups.Group A included 191 patients who were diagnosed as chronic severe-type hepatitis with underlying hepatocirrhosis,and group B including 175 patients with the same diagnosis as group A but underlain with chronic hepatitis,and group C,as control group,including 155 patients who were diagnosed as acute jaundiced hepatitis.All cases were examined with by endoscopy within 3 d after their being hospitalized.Results In Group A,there were 131 cases(68.6%) who was found the minifestations of portal hypertensive gastropathy(PHG),and acute gastric mucosal lesion(AGML) in 81 cases(42.4%),and in group B,PHG and AGML were found in 119 cases(68.0%)and 79 cases(45.1%),respectively.In group C,PHG and AGML were found in 11 cases(7.0%)and 21 cases(13.5%),respectively.There was no significant difference between the numbers of cases with PHG in group A and those in group B,so did the numbers of AGML.Compared with group C,there was significant difference in terms of either PHG or AGML in group A,and so did in group B compared with group C.Conclusion PHG and AGML pravelence present frequently in patients with chronic severe-type hepatitis underlain with either hepatocirrhosis or chronic hepatitis,and the appearance rates of the two kinds of lesions were much greatly in patients with chronic severe-type hepatitis than patients with acute jaundiced hepatitis.The presence of PHG /AGML is related to chronic liver disease(CLD) probably.