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目的分析肝炎后肝硬化(LC)门静脉高压性胃病(PHG)的内镜像及临床特征。方法北京地坛医院2007年1月至2009年8月收治的768例LC患者,对经电子胃镜检查确诊合并PHG的100例作回顾性分析。结果 100例患者中轻度PHG59例,重度PHG41例,77例幽门螺杆菌(Hp)检测呈阳性。PHG内镜像特征:轻度:(1)黏膜表面细小红点灶(猩红热样疹);(2)在条纹状外观的黏膜皱褶表面出现表浅红斑;(3)红粉色水肿黏膜上出现黄白色网状间隔,类似蛇皮样或马赛克样改变。重度:黏膜出现樱桃红斑点和(或)弥漫出血性胃炎,其中以马赛克样改变最常见,且多发于胃底和胃体。结论猩红热样疹、马赛克样变、樱桃红斑点是PHG最具特征的内镜像。PHG的严重程度与肝功能分级呈正相关。PHG临床表现无明显特征性,只能通过胃镜检查确诊。
Objective To analyze the endoscopic features and clinical features of posthepatitic cirrhosis (LC) with portal hypertension gastropathy (PHG). Methods A total of 768 LC patients admitted to Ditan Hospital in Beijing from January 2007 to August 2009 were retrospectively analyzed in 100 patients diagnosed with PHG by electronic endoscopy. Results In 100 cases, mild PHG was found in 59 cases, severe PHG in 41 cases and 77 cases of H. pylori (Hp). PHG endoscopic features: Mild: (1) mucosal surface of small red spot stove (scarlet fever rash); (2) in the appearance of striped mucosal folds superficial erythema; (3) red pink edema on the mucous membrane appears yellow White reticular spacing, similar to snakeskin or mosaic-like changes. Severe: Cherry mucosa erythema spots and (or) diffuse hemorrhagic gastritis, of which the mosaic-like changes the most common, and mainly in the stomach and stomach. Conclusion Scarlet fever-like rash, mosaic-like changes, cherry erythema is the most characteristic endoscopic PHG. The severity of PHG was positively correlated with the grade of liver function. PHG clinical manifestations no obvious characteristic, only confirmed by gastroscopy.