Congestive Gastropathy in Cirrhotic Patients: Correlation between Endoscopic and Histological Findings

肝硬化病人之鬱血性胃病變其內視鏡及組織學表徵之探討

楊旻達(Min-Ta Yang) ； 鄭勇山(Yeong-Shon Jeng) ； 柯富聰(Fu-Tsong Ko) ； 王朝欣(Chaur-Shing Wang) ； 林光洋(Kuang-Yane Lin) ； 劉正典(Jean-Dean Liu) ； 蕭泉豹(Chuan-Pau Siauw) ； 陳寶輝(Pao-Huei Chen) ； 施麗順(Li-Shun Shih)

《The Kaohsiung Journal of Medical Sciences》 11卷1期 (1995/01) Pp. 15-20

https://doi.org/10.6452/KJMS.199501.0015

摘要

鬱血性胃病變是常造成肝硬化病人出血原因之一，我們對年齡、性別無差異之兩組病人，包括46位肝硬化及225位非肝硬化，研究鬱血性胃病變之發生率及其內視鏡及組織學上的相關。本研究顯示，內視鏡下鬱血性性胃病變在霋硬化病人發生率高於對照組，其敏感度為85%，特異度95%，正預測值76%；且其與肝病嚴重程度有關，但和肝硬化原因及食道靜脈瘤大小及紅色徵兆有無並無相關。內視鏡切片，我們研究組織學上的特徵包括胃炎、間質水腫、血管擴張／充血及血鐵質和內視鏡下鬱性胃病變皆無相關。因此我們的結論是：（1）鬱性胃病變常見於肝硬病人且和肝病嚴重程度有關。（2）鬱血性胃病變其黏膜組織學變化並無特異性。

並列摘要

Congestive gastropathy is a common cause of gastrointestinal bleeding in cirrhotic patients. Forty-six patients with cirrhosis of the liver and 225 control subjects matched in age and sex without cirrhosis of the liver entered the study. We studied the prevalence of congestive gastropathy in cirrhotic patients, and the relationship between endoscopic and histological findings. Congestive gastropathy seen endoscopically was found to be more common in the cirrhotic group than in the control (85% vs. 5%, P＜0.05). The sensitivity, specificity and positive predictive value were 85%, 95% and 76%, respectively. The presence of endoscopic congestive gastropathy was correlated with the severity of liver disease (P＜0.05), but not to the etiology of cirrhosis and the size of esophageal varices with or without red color sign. Endoscopic congestive gastropathy showed no correlation with the histological features including gastritis, interstitial edema, vessel ectasia/congestion and hemosiderin in edoscopic biopsy specimens. In conclusion, congestive gastropathy is a common finding in cirrhotic patients. Its appearance is closely correlated with the severity of liver disease. There is no good correlation between endoscopic congestive gastropathy and mucosal histology.

並列關鍵字

congestive gastropathy ； portal hypertension ； vessel ectasia/congestion