血吸虫病肝纤维化门脉高压性胃病影响因素分析

中国寄生虫学与寄生虫病杂志 ›› 2003, Vol. 21 ›› Issue (4): 10-229.

血吸虫病肝纤维化门脉高压性胃病影响因素分析

楼雅依,乌文琳,陆其明

浙江省嘉兴医学院附属第一医院,嘉兴 314000

收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2003-08-30 发布日期:2003-08-30

Factors Influencing the Development of Portal Hypertensive Gastropathy with Liver Fibrosis in Schistosomiasis

LOU Ya-yi,WU Wen-lin,LU Qi-ming

First Municipal Hospital of Jiaxing City,Jiaxing 314000

Received:1900-01-01 Revised:1900-01-01 Online:2003-08-30 Published:2003-08-30

摘要/Abstract

摘要： 　　目的观察血吸虫病肝纤维化形成门脉高压性胃病(PHG)的影响因素。方法回顾性分析近5年来资料完整、胃镜检查证实的血吸虫病肝纤维化门脉高压症食管静脉曲张的住院患者196例(合并PHG109例)。将PHG的发生率与食管静脉曲张严重程度、肝功能ChildPugh分级的关系作对照。结果食管静脉曲张轻、中、重度患者的PHG发生率分别为47.7％(21/44)、54.8％(23/42)及59.1％(65/110),比较相互间差异均无显著性意义(P>0.05)。ChildPugh外分级A、B、C级的PHG发生率分别为56.0％(47/84)、53.3％(48/90)及63.6％(14/22),比较相互间差异均无显著性意义(P>0.05)。未经任何手术治疗的PHG发生率为51.3％(61/119),切脾术后为50.0％(19/38),两者间差异无显著性意义(P>0.05)。切脾+断流术后为70.6％(12/17),食管静脉曲张硬化治疗术后为85.0％(17/20),与未经任何手术治疗者间的差异均有显著性意义(P<0.05)。结论血吸虫病肝纤维化门脉高压症中PHG的发生率与食管静脉曲张严重程度及肝功能ChildPugh分级无关。PHG发生率在切脾+断流术、食管静脉曲张硬化治疗术后增加,而单纯作切脾术后无显著变化。

关键词: 血吸虫病肝纤维化, 门脉高压性胃病, 切脾+断流术, 食管静脉曲张硬化治疗术

Abstract: 　Objective To evaluate the factors influencing the development of portal hypertensive gastropathy
PHG with liver fibrosis in schistosomiasis japonica. Methods A retrospective study was executed on 196 hospitalized patients with schistosomiasis liver fibrosis (109 of them complicated with PHG) from 1998 to 2002. Endoscopic examina- tions were carried out for all the cases. The analysis was made with a comparison of the PHG incidence to the degree of esophageal varices and the degree of liver function according to Child Pugh's scores. Results With slight, moderate and severe degree of esophageal varices, the PHG incidence was 47. 7%, 54. 8%, and 59. 1% respectively (P>0. 05). With the Child pugh's classes of A, B and C, the PHG incidence was 56. 0%, 53. 3%, and 63. 6% respectively (P> 0. 05). With no surgical intervention, it was 51. 3%, and with splenectomy, only 50. 0%. With splenectomy plus an oper- ation of transection and an endoscopic sclerotherapy, it was 70. 6% and 85. 0%. The PHG incidence was significantly high- er in the group of splenectomy plus operation of transection and the group with endoscopic sclerotherapy than the group with no surgical intervention (P<0. 05). Conclusion The PHG incidence in schistosomiasis liver fibrosis has no relationship with the degree of esophageal varices and Child Pugh classes of liver function. However, splenectomy plus transection and endoscopic sclerotherapy may accelerate the PHG development.

Key words: schistosomiasis liver fibrosis, portal hypertensive gastropathy (PHG), splenectomy and transection, sclerotherapy

楼雅依;乌文琳;陆其明. 血吸虫病肝纤维化门脉高压性胃病影响因素分析[J]. 中国寄生虫学与寄生虫病杂志, 2003, 21(4): 10-229.

LOUYa-yi;WUWen-lin;LUQi-ming. Factors Influencing the Development of Portal Hypertensive Gastropathy with Liver Fibrosis in Schistosomiasis[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2003, 21(4): 10-229.

[1]	黄维恒,姚作平,何晓玲. B超与血清透明质酸对日本血吸虫病肝脏纤维化的评估[J]. 中国寄生虫学与寄生虫病杂志, 1996, 14(3): 2-2.
[2]	刘平,张礼邦,刘成,徐列明,薛惠明,唐民圭,阮望春,洪嘉禾,俞广声,李文,王玉润. 兔血吸虫病肝纤维化形成过程中肝内胶原代谢的动态变化及其意义[J]. 中国寄生虫学与寄生虫病杂志, 1988, 6(3): 202-204.
[3]	罗光构,方爱珍,刘井元,鲁敏,邓爱群,黄雨英,朱凤华,王在华. 血管扩张药对血吸虫病动物肝胶原含量的影响[J]. 中国寄生虫学与寄生虫病杂志, 1988, 6(2): 147-147.
[4]	徐麦玲,马德颖,魏承慈,徐肇玥,徐佩佩,戈顺娣,陆明廉. 血吸虫病肝纤维化动物某些生化指标的检测及其意义[J]. 中国寄生虫学与寄生虫病杂志, 1985, 3(4): 266-268.