肝硬化患者结肠镜下表现及其相关因素分析

目的探讨肝硬化患者结肠镜下表现,及这些病变与肝功能Child-Pugh分级、食管静脉曲张程度、肝纤维化指标（APRI指数）等相关因素的关系。方法回顾性分析本院2009年1月至2012年5月收治的172例肝硬化住院患者临床资料,23例患者行结肠镜检查,同时分析肠镜表现与肝功能,食管静脉曲张程度以及APRI指数的关系。结果 172例患者中共23例患者行结肠镜检查,最常见病变为门静脉高压性结肠病（PHC）（9/23,39.1%）,完全正常比例仅有8.7%（2/23）。PHC的发生与患者中重度食管静脉曲张有相关趋势（P=0.086）,与患者严重肝纤维化（APRI指数大于1.08）和肝功能Child-Pugh评分无关。结论多达91.3%的肝硬化患者结肠镜表现异常,39.1%患者表现为PHC,需要对肝硬化患者进行结肠镜检查。

Colonoscopy-based diagnosis of portal hypertensive colopathy in cirrhotic patients and relation to hepatic disease pathogenesis

Objective To evaluate the rate of colonoscopy-based diagnosis of portal hypertensive colopathy（PHC） in patients with cirrhosis and evaluate associations with the hepatic disease pathogenic features.Methods Twenty-three cirrhotic patients who underwent colonoscopy between January 2009 and May 2012 were enrolled in the study.The colonoscopy examination results,Child-Pugh scores,esophageal varices stages,and aspartate aminotransferase to platelet ratio index（APRI） values were recorded for each patient.The significance of inter-group differences was assessed by Chi-squared test or Fisher′s exact test.Results The most common colonoscopy finding was PHC（9/23,39.1%）.Only 8.7%（2/23） of patients had completely normal findings.Occurrence of PHC was associated with moderate to severe esophageal varices（P=0.086） but not with severe liver fibrosis,either by APRI index or Child-Pugh score.Conclusion The majority of cirrhosis patients had anomalous colonoscopy findings,and more than one-third had PHC.Colonoscopy should be considered for cirrhotic patients to identify previously undiagnosed PHC and initiate timely treatment.