Clinical Analysis Of 62 Patients With Portal Hypertensive Gastropathy In Hepatic Cirrhosis

Portal hypertensive gastropathy (PHG), a term used to describe non-inflammation gastropathy with a characteristic gastric mucosa and submucosa vascular pathological changes including capillary expansi- on, congestion, artery-vein short and ultrastructure changes of capilla- ry endothelial and mucosal endothelial cell, is a common finding in li- ver cirrhosis patients with portal hypertension. The pathogenesis is sti- ll indefinite, and currently the common agreement is the dysfunction of the gastric mucosal hemodynamics and molecular cytology. The co- mmon clinic manifestation is chronic and occult digestive hemorrhage, and often has the first symptom of melena, and hematemesis is only a- ssociation with severe PHG. The diagnosis mainly depended on the e- ndoscopic appearance, but it can be difficult to differentiate from GA- VE syndrome. The principal treatment of PHG is reducing portal pr- essure, preventing bleeding, treating acute hemorrhage andprophylaxis of rebleeding and regularly beginning with medical treatment.Objective To analyze the relationship of the portal hype- rtensive gastropathy(PHG) and the three main clinical presentations and Child-Pugh classification. Moreover, to evaluate the prevalence of PHG related bleeding in all cirrhotic patients with upper digestive he- morrhage. Methods 147 patients with cirrhotic patients who were in hospital between January 2005 and March 2008 were randomized selected in the study. We made a retrospective analysis according to the experimental check results of the liver function, blood coagulation and abdominal ultrasound and endoscopic check. Results There were 62 PHG(40 men, 22 woman) in the 147 cirrhotic patients. 130(88.4%) had esophageal varices, 81(55.1%)had splenomegaly, 96(65.3%)had ascites. Child-Pugh classification A were 43(29.3%), B were 70(47.6 %), C were 34(23.1%). Complicated with upper digestive hemorrhage were 112(76.2%), including 30(26.8%) portal hypertension related bl- eeding, variceal bleeding were 63(56.2%), ulceric hemorrhage were 19(17.0%). In the cases of PHG related bleeding, the bleeding rate ha- ve no significant relationship with the child-Pugh classification.Conclusion The prevalence of PHG did not vary from sex and ages The more serious the esophageal varices was, the higher incidence rate of PHG, but the degree of PHG did not vary from the degree of the va- rices. The prevalence of PHG did not differ regarding the splenomega- ly, ascites and Child-Pugh classification. In all cirrhosis related hemo- rrhage the proportion of PHG related bleeding is only secondly to var- iceal bleeding. No or small varice with bleeding is mainly because of PHG, and large varice with bleeding is mainly because of vein rupture. The prevalence of PHG related bleeding have no difference between the Child-Pugh classification.