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肝硬化患者结肠镜下表现及其相关因素分析
Colonoscopy-based diagnosis of portal hypertensive colopathy in cirrhotic patients and relation to hepatic disease pathogenesis
文章发布日期： 2013年05月04日 作者： 陈林艳，夏时海，王毓麟，等
下载次数:126次 点击次数:520次 【中文摘要】：目的探讨肝硬化患者结肠镜下表现，及这些病变与肝功能Child-Pugh分级、食管静脉曲张程度、肝纤维化指标（APRI指数）等相关因素的关系。方法回顾性分析本院2009年1月至2012年5月收治的172例肝硬化住院患者临床资料， 23例患者行结肠镜检查，同时分析肠镜表现与肝功能，食管静脉曲张程度以及APRI指数的关系。结果172例患者中共23例患者行结肠镜检查，最常见病变为门静脉高压性结肠病（PHC）（9/23,39.1%），完全正常比例仅有8.7%（2/23）。PHC的发生与患者中重度食管静脉曲张有相关趋势(P=0.086)，与患者严重肝纤维化（APRI指数大于1.08）和肝功能Child-Pugh评分无关。结论多达913%的肝硬化患者结肠镜表现异常，39.1%患者表现为PHC，需要对肝硬化患者进行结肠镜检查。
【英文摘要】：ObjectiveTo evaluate the rate of colonoscopy-based diagnosis of portal hypertensive colopathy (PHC) in patients with cirrhosis and evaluate associations with the hepatic disease pathogenic features. MethodsTwenty-three cirrhotic patients who underwent colonoscopy between January 2009 and May 2012 were enrolled in the study. The colonoscopy examination results, Child-Pugh scores, esophageal varices stages, and aspartate aminotransferase to platelet ratio index (APRI) values were recorded for each patient. The significance of inter-group differences was assessed by Chi-squared test or Fisher′s exact test. ResultsThe most common colonoscopy finding was PHC (9/23, 39.1%). Only 8.7% (2/23) of patients had completely normal findings. Occurrence of PHC was associated with moderate to severe esophageal varices (P=0.086) but not with severe liver fibrosis, either by APRI index or Child-Pugh score. ConclusionThe majority of cirrhosis patients had anomalous colonoscopy findings, and more than one-third had PHC. Colonoscopy should be considered for cirrhotic patients to identify previously undiagnosed PHC and initiate timely treatment.
【中文关键字】：结肠镜；肝硬化；食管和胃静脉曲张；高血压，门静脉
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