• 吉林大學(xué)中日聯(lián)誼醫(yī)院胃腸外科(長春130031);

門脈高壓性胃病是肝硬變門脈高壓癥患者的主要并發(fā)癥之一，病變幾乎累及全部消化道，現(xiàn)就門脈高壓性胃病的臨床表現(xiàn)、病理特點、發(fā)病機理、診斷與治療討論如下……

引用本文： 蓋保東,王正峰,劉東. 門脈高壓性胃病. 中國普外基礎(chǔ)與臨床雜志, 2008, 15(12): 880-882. doi: 復(fù)制

1. Sarfeh IJ, Juler GL, Stemmer EA, et al. Results of surgical management of hemorrhagic gastritis in patients with gastroesophageal varices [Ｊ]. Surg Gynecol Obstet, 1982; 155(2)∶ 167.
2. McCormack TT, Sims J, Eyre-Brook I, et al. Gastric lesions in portal hypertension: inflammatory gastritis or congestive gastropathy? [Ｊ]. Gut, 1985; 26(11)∶ 1226.
3. Tarnawski AS, Sarfeh IJ, Stachura J, et al. Microvascular abnormalities of the portal hypertensive gastric mucosa [Ｊ]. Hepatology, 1988; 8(6)∶ 1488.
4. Thiruvengadam R, Gostout CJ. Congestive gastroenteropathy-an extension of nonvariceal upper gastrointestinal bleeding in portal hypertension [Ｊ]. Gastrointest Endosc, 1989; 35(6)∶504.
5. Kozarek RA, Botoman VA, Bredfeldt JE, et al. Portal colopathy: prospective study of colonoscopy in patients with portal hypertension [Ｊ]. Gastroenterology, 1991; 101(5)∶ 1192.
6. Viggiano TR, Gostout CJ. Portal hypertensive intestinal vasculopathy: a review of the clinical, endoscopic, and histopathologic features [Ｊ]. Am J Gastroenterol, 1992; 87(8)∶ 944.
7. Spina GP, A rcidiacono R, Bosch J, et al. Gastric endoscopic features in portal hypertension: final report of a consensus conference, Milan, Italy, September 19,1992 [Ｊ]. J Hepatol, 1994; 21(3)∶ 461.
8. Tanoue K, Hashizume M, Wada H, et al. Effects of endoscopic injection sclerotherapy on portal hypertensive gastropathy: a prospective study [Ｊ]. Gastrointest Endosc, 1992; 38(5)∶ 582.
9. Ichikawa Y, Tarnawski A, Sarfeh IJ, et al. Distorted microangioarchitecture and impaired angiogenesis in gastric mucosa of portal hypertensive rats [Ｊ]. Gastroenterology, 1994; 106(3)∶ 702.
10. Sarfeh IJ, Tarnawski A, Malki A, et al. Portal hypertension and gastric mucosal injury in rats. Effects of alcohol [Ｊ]. Gastroenterology, 1983; 84(5 Pt 1)∶ 987.
11. 黃白平, 袁順玉， 崔淑芬, 等. 胃泌素和胃酸對門脈高壓下胃黏膜的影響 [Ｊ]. 中華消化雜志, 1989; 9(4)∶ 210.
12. 趙玉海. 5-羥色胺阻滯劑治療門脈高壓研究近況 [Ｊ]. 臨床內(nèi)科雜志, 1995; 12(2)∶ 8.
13. 張翠萍, 張 琪, 楊立廷, 等. 門脈高壓性胃病患者血清胃泌素、生長抑素和胰高糖素的研究 [Ｊ]. 實用肝臟病雜志, 2000; 8(3)∶ 16.
14. 吳 靜. 肝硬變及伴門脈高壓性胃病患者血漿胃泌素變化的臨床研究 [Ｊ]. 臨床肝膽病雜志, 1997; 13(3)∶ 156.
15. 周黎黎. 門脈高壓性胃病一氧化氮、內(nèi)皮素、胃泌素的變化及相關(guān)性探討 [Ｊ]. 四川醫(yī)學(xué), 2003; 24(1)∶ 74.
16. 余立凱, 尹朝禮, 王天才, 等. 門脈高壓兔胃壁的NADPH黃遞酶組織化學(xué)觀察 [Ｊ]. 中國組織化學(xué)與細胞化學(xué)雜志, 2000; 9(1)∶ 58.
17. 于皆平, 沈志祥, 羅和生主編. 實用消化病學(xué) [M]. 第1版. 北京: 科學(xué)出版社, 1999∶ 1063～1065.
18. Isobe H, Sakai H, Satoh M, et al. Delayed gastric emptying in patients with liver cirrhosis [Ｊ]. Dig Dis Sci, 1994; 39(5)∶ 983.
19. Acalovschi M, Dumitrascu DL, Csakany I. Gastric and gall bladder emptying of a mixed meal are not coordinated in liver cirrhosis-a simultaneous sonographic study [Ｊ]. Gut, 1997; 40(3)∶ 412.
20. Vigneri S, Termini R, Piraino A, et al. The stomach in liver cirrhosis. Endoscopic, morphological, and clinical correlations[Ｊ]. Gastroenterology, 1991; 101(2)∶ 472.
21. Galati JS, Holdeman KP, Dalrymple GV, et al. Delayed gastric emptying of both the liquid and solid components of a meal in chronic liver disease [Ｊ]. Am J Gastroenterol, 1994; 89(5)∶ 708.
22. Gunal O, Yegen C, Aktan AO, et al. Gastric functions in portal hypertension. Role of endothelin [Ｊ]. Dig Dis Sci, 1996; 41(3)∶ 585.
23. Charneau J, Petit R, Cales P, et al. Antral motility in patients with cirrhosis with or without gastric antral vascular ectasia [Ｊ]. Gut, 1995; 37(4)∶ 488.
24. 蔣曉華, 史 峰. 門脈高壓患者空腹胃運動障礙的臨床研究 [Ｊ]. 胃腸病學(xué)和肝病學(xué)雜志, 1997; 6(1)∶ 59.
25. 樂橋良， 張 捷， 許其增， 等. 奧曲肽對門靜脈高壓性胃病胃粘膜大出血的療效 [Ｊ]. 中華肝臟病雜志, 2002; 10(1)∶ 68.
26. McTavish D, Buckley MM, Heel RC. Omeprazole. An updated review of its pharmacology and therapeutic use in acid-related disorders [Ｊ]. Drugs, 1991; 42(1)∶ 138.
27. Hosokawa Y. Mucosal lesions of the stomach in liver cirrhosis with a special reference to phospholipid metabolism [Ｊ]. Gastroenterol Jpn, 1991; 26(3)∶ 329.
28. 向 華,錢 偉,陳 婕,等.環(huán)氧合酶-1和前列腺素E2在多潘立酮對大鼠胃黏膜保護中的作用[Ｊ].中華消化雜志,2004; 24(12)∶ 732.
29. Whittle BJ, Lopez-Belmonte J, Moncada S. Regulation of gastric mucosal integrity by endogenous nitric oxide: interactions with prostanoids and sensory neuropeptides in the rat [Ｊ]. Br J Pharmacol, 1990; 99(3)∶ 607.
30. 蔣宗惠. 中西醫(yī)結(jié)合治療肝硬化門脈高壓致胃腸粘膜糜爛大出血30例 [Ｊ]. 江蘇中醫(yī), 1997; 18(11)∶ 19.
  1. 1. Sarfeh IJ, Juler GL, Stemmer EA, et al. Results of surgical management of hemorrhagic gastritis in patients with gastroesophageal varices [Ｊ]. Surg Gynecol Obstet, 1982; 155(2)∶ 167.
  2. 2. McCormack TT, Sims J, Eyre-Brook I, et al. Gastric lesions in portal hypertension: inflammatory gastritis or congestive gastropathy? [Ｊ]. Gut, 1985; 26(11)∶ 1226.
  3. 3. Tarnawski AS, Sarfeh IJ, Stachura J, et al. Microvascular abnormalities of the portal hypertensive gastric mucosa [Ｊ]. Hepatology, 1988; 8(6)∶ 1488.
  4. 4. Thiruvengadam R, Gostout CJ. Congestive gastroenteropathy-an extension of nonvariceal upper gastrointestinal bleeding in portal hypertension [Ｊ]. Gastrointest Endosc, 1989; 35(6)∶504.
  5. 5. Kozarek RA, Botoman VA, Bredfeldt JE, et al. Portal colopathy: prospective study of colonoscopy in patients with portal hypertension [Ｊ]. Gastroenterology, 1991; 101(5)∶ 1192.
  6. 6. Viggiano TR, Gostout CJ. Portal hypertensive intestinal vasculopathy: a review of the clinical, endoscopic, and histopathologic features [Ｊ]. Am J Gastroenterol, 1992; 87(8)∶ 944.
  7. 7. Spina GP, A rcidiacono R, Bosch J, et al. Gastric endoscopic features in portal hypertension: final report of a consensus conference, Milan, Italy, September 19,1992 [Ｊ]. J Hepatol, 1994; 21(3)∶ 461.
  8. 8. Tanoue K, Hashizume M, Wada H, et al. Effects of endoscopic injection sclerotherapy on portal hypertensive gastropathy: a prospective study [Ｊ]. Gastrointest Endosc, 1992; 38(5)∶ 582.
  9. 9. Ichikawa Y, Tarnawski A, Sarfeh IJ, et al. Distorted microangioarchitecture and impaired angiogenesis in gastric mucosa of portal hypertensive rats [Ｊ]. Gastroenterology, 1994; 106(3)∶ 702.
  10. 10. Sarfeh IJ, Tarnawski A, Malki A, et al. Portal hypertension and gastric mucosal injury in rats. Effects of alcohol [Ｊ]. Gastroenterology, 1983; 84(5 Pt 1)∶ 987.
  11. 11. 黃白平, 袁順玉， 崔淑芬, 等. 胃泌素和胃酸對門脈高壓下胃黏膜的影響 [Ｊ]. 中華消化雜志, 1989; 9(4)∶ 210.
  12. 12. 趙玉海. 5-羥色胺阻滯劑治療門脈高壓研究近況 [Ｊ]. 臨床內(nèi)科雜志, 1995; 12(2)∶ 8.
  13. 13. 張翠萍, 張 琪, 楊立廷, 等. 門脈高壓性胃病患者血清胃泌素、生長抑素和胰高糖素的研究 [Ｊ]. 實用肝臟病雜志, 2000; 8(3)∶ 16.
  14. 14. 吳 靜. 肝硬變及伴門脈高壓性胃病患者血漿胃泌素變化的臨床研究 [Ｊ]. 臨床肝膽病雜志, 1997; 13(3)∶ 156.
  15. 15. 周黎黎. 門脈高壓性胃病一氧化氮、內(nèi)皮素、胃泌素的變化及相關(guān)性探討 [Ｊ]. 四川醫(yī)學(xué), 2003; 24(1)∶ 74.
  16. 16. 余立凱, 尹朝禮, 王天才, 等. 門脈高壓兔胃壁的NADPH黃遞酶組織化學(xué)觀察 [Ｊ]. 中國組織化學(xué)與細胞化學(xué)雜志, 2000; 9(1)∶ 58.
  17. 17. 于皆平, 沈志祥, 羅和生主編. 實用消化病學(xué) [M]. 第1版. 北京: 科學(xué)出版社, 1999∶ 1063～1065.
  18. 18. Isobe H, Sakai H, Satoh M, et al. Delayed gastric emptying in patients with liver cirrhosis [Ｊ]. Dig Dis Sci, 1994; 39(5)∶ 983.
  19. 19. Acalovschi M, Dumitrascu DL, Csakany I. Gastric and gall bladder emptying of a mixed meal are not coordinated in liver cirrhosis-a simultaneous sonographic study [Ｊ]. Gut, 1997; 40(3)∶ 412.
  20. 20. Vigneri S, Termini R, Piraino A, et al. The stomach in liver cirrhosis. Endoscopic, morphological, and clinical correlations[Ｊ]. Gastroenterology, 1991; 101(2)∶ 472.
  21. 21. Galati JS, Holdeman KP, Dalrymple GV, et al. Delayed gastric emptying of both the liquid and solid components of a meal in chronic liver disease [Ｊ]. Am J Gastroenterol, 1994; 89(5)∶ 708.
  22. 22. Gunal O, Yegen C, Aktan AO, et al. Gastric functions in portal hypertension. Role of endothelin [Ｊ]. Dig Dis Sci, 1996; 41(3)∶ 585.
  23. 23. Charneau J, Petit R, Cales P, et al. Antral motility in patients with cirrhosis with or without gastric antral vascular ectasia [Ｊ]. Gut, 1995; 37(4)∶ 488.
  24. 24. 蔣曉華, 史 峰. 門脈高壓患者空腹胃運動障礙的臨床研究 [Ｊ]. 胃腸病學(xué)和肝病學(xué)雜志, 1997; 6(1)∶ 59.
  25. 25. 樂橋良， 張 捷， 許其增， 等. 奧曲肽對門靜脈高壓性胃病胃粘膜大出血的療效 [Ｊ]. 中華肝臟病雜志, 2002; 10(1)∶ 68.
  26. 26. McTavish D, Buckley MM, Heel RC. Omeprazole. An updated review of its pharmacology and therapeutic use in acid-related disorders [Ｊ]. Drugs, 1991; 42(1)∶ 138.
  27. 27. Hosokawa Y. Mucosal lesions of the stomach in liver cirrhosis with a special reference to phospholipid metabolism [Ｊ]. Gastroenterol Jpn, 1991; 26(3)∶ 329.
  28. 28. 向 華,錢 偉,陳 婕,等.環(huán)氧合酶-1和前列腺素E2在多潘立酮對大鼠胃黏膜保護中的作用[Ｊ].中華消化雜志,2004; 24(12)∶ 732.
  29. 29. Whittle BJ, Lopez-Belmonte J, Moncada S. Regulation of gastric mucosal integrity by endogenous nitric oxide: interactions with prostanoids and sensory neuropeptides in the rat [Ｊ]. Br J Pharmacol, 1990; 99(3)∶ 607.
  30. 30. 蔣宗惠. 中西醫(yī)結(jié)合治療肝硬化門脈高壓致胃腸粘膜糜爛大出血30例 [Ｊ]. 江蘇中醫(yī), 1997; 18(11)∶ 19.