门脉高压性胃病与食管静脉曲张、门脾静脉内径及肝功能关系的探讨

A study of relation between portal hypertensive gastroenteropathy and esophageal varicosity and diameter of portal or splenic vein and changes of hepatic function

目的 :探讨门脉高压性胃病 (PHG)的发生与门脉高压、肝功能改变的关系。方法 :86例肝硬化病人行肝功能检测、B超探查及胃镜检查。PHG分为轻型和重型 ,比较两型PHG的检出率与食管静脉曲张程度 ,门、脾静脉内径及Child肝功能分级的关系。结果 :共检出PHG 73例 ,检出率 84 9% ,其中轻型 32例 ,重型 4 1例 ,两组中轻度、中度、重度食管静脉曲张检出率分别为 1 5 6 %、34 4 %、4 3 8%和 1 7 1 %、2 6 8%、5 6 1 % (P >0 0 5 ) ,两组中门、脾静脉内径分别为 1 31± 0 2 9cm、0 91± 0 2 1cm和 1 4 9± 0 4 1cm、1 0 1± 0 2 3cm(P <0 0 5和 >0 0 5 ) ,两组中ChildA、B、C分级分别占 9 4 %、2 5 0 %、6 5 6 %和 4 9%、31 7%、6 3 4 % (P >0 0 5 )。结论 :PHG轻重与食管静脉曲张程度关系不明显 ;两组间门静脉内径有差异 ,可作为预测PHG轻重的指标 ;

Objective:To study existence of portal hypertensive gastroenteropathy(PHG) which was probably relative to the occurrence of portal hypertension and the changes of hepatic function.Methods:86 patients with cirrhosis due to chronic virus hepatitis accepted hepatic functional test,B ultrasonic check and endoscopy.PHG was classified into type light and type heavy.The rates of each degree of esophageal varicosity,interior diameters of portal and splenic vein,as well as the Childs grades were compared between the two types.Results:73 cases of PHG were detected,with positive rate of 84 9%,type light 32,and type heavy 41 Between them,the positive rate of each degree of esophageal varicosity was light degree 15 6%,17 1%,moderate degree 34 4%,26 8% and heavy degree 43 8%,56.1% respectively(P>0 05),while the interior diameter of portal and splenic vein was 1 31±0 29cm,0 91±0 21cm and 1 49±0 41cm,1 01±0 23cm respectively(P<0 05 and P>0 05),but Childs degree of A,B,C occupied 9 4%,25 0%,65 6% and 4 9%,31 7%,63 4% respectively(P>0 05).Conclusions:The extent of PHG does not obviously link to the degrees of esophageal varicosity.The interior diameter of portal vein could be treated as a guideline to forecast the occurrence of PHG for its significant difference between the two types.The change of hepatic function is another influential factor.