中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

肝硬化门静脉高压导致的胃肠结构和功能改变及其临床表现

尚祉胤 杨敬貌 陈丽萍 刘敏 程开 李耀华 艾迎春 程计林

引用本文:
Citation:

肝硬化门静脉高压导致的胃肠结构和功能改变及其临床表现

DOI: 10.3969/j.issn.1001-5256.2017.02.034
详细信息
  • 中图分类号: R575.21

Changes in gastrointestinal structure and function caused by cirrhotic portal hypertension and related clinical manifestations

  • 摘要: 临床上高达80%的肝硬化门静脉高压患者存在不同程度胃肠症状,这与肝硬化门静脉高压导致的胃肠结构改变、胃肠功能失调及神经体液调节改变有关。回顾了肝硬化门静脉高压对胃肠结构改变、胃肠功能失调及神经体液调节改变的影响,以及这些改变所导致的消化道临床表现,提示对肝硬化门静脉高压胃肠结构改变进行研究,可以有效地预防和治疗肝硬化的并发症,改善胃肠症状;另外,对胃肠功能进行调节,可改善患者症状,有助于延缓肝硬化进展,建议定期内窥镜评估肝硬化患者胃肠黏膜和血管的改变,有助于早期治疗和减少并发症。

     

  • [1]KALAITZAKIS E.Gastrointestinal dysfunction in liver cirrhosis[J].World J Gastroenterol,2014,20(40):14686-14695.
    [2]URRUNAGA NH,ROCKEY DC.Portal hypertensive gastropathy and colopathy[J].Clin Liver Dis,2014,18(2):389-406.
    [3]CHUNG WJ.Management of portal hypertensive gastropathy and other bleeding[J].Clin Mol Hepatol,2014,20(1):1-5.
    [4]NOJKOV B,CAPPELL MS.Distinctive aspects of peptic ulcer disease,Dieulafoy's lesion,and Mallory-Weiss syndrome in patients with advanced alcoholic liver disease or cirrhosis[J].World J Gastroenterol,2016,22(1):446-466.
    [5]MEKAROONKAMOL P,COHEN R,CHAWLA S.Portal hypertensive enteropathy[J].World J Hepatol,2015,7(2):127-138.
    [6]JEON SR,KIM JO.Capsule endoscopy for portal hypertensive enteropathy[J].Gastroenterol Res Pract,2016,2016:8501394.
    [7]ELAMIN EE,MASCLEE AA,DEKKER J,et al.Ethanol metabolism and its effects on the intestinal epithelial barrier[J].Nutr Rev,2013,71(7):483-499.
    [8]AL-BUSAFI SA,McN ABB-BALTAR J,FARAG A,et al.Clinical manifestations of portal hypertension[J].Int J Hepatol,2012,2012:203794.
    [9]HOU Y.The clinical comparision of cirrhosis patients with different etiological upper digestive tract hemorrhage[J].J Clin Exp Med,2015,14(12):999-1001.(in Chinese)侯昀.肝硬化不同病因上消化道出血患者的临床对比[J].临床和实验医学杂志,2015,14(12):999-1001.
    [10] SHARMA M,RAMESHBABU CS.Collateral pathways in portal hypertension[J].J Clin Exp Hepatol,2012,2(4):338-352.
    [11]PILLAI AK,ANDRING B,PATEL A,et al.Portal hypertension:a review of portosystemic collateral pathways and endovascular interventions[J].Clin Radiol,2015,70(10):1047-1059.
    [12]KAPOOR A,DHAREL N,SANYAL AJ.Endoscopic diagnosis and therapy in gastroesophageal variceal bleeding[J].Gastrointest Endosc Clin N Am,2015,25(3):491-507.
    [13]WU Q,SHEN L,CHU J,et al.Characterization of uncommon portosystemic collateral circulations in patients with hepatic cirrhosis[J].Oncol Lett,2015,9(1):347-350.
    [14]QI X,LI H,LIU X,et al.Novel insights into the development of portal vein thrombosis in cirrhosis patients[J].Expert Rev Gastroenterol Hepatol,2015,9(11):1421-1432.
    [15]MASTORAKI A,MASTORAKI S,TZIAVA E,et al.Mesenteric ischemia:pathogenesis and challenging diagnostic and therapeutic modalities[J].World J Gastrointest Pathophysiol,2016,7(1):125-130.
    [16]NORMAN K,PIRLICH M.Gastrointestinal tract in liver disease:which organ is sick?[J].Curr Opin Clin Nutr Metab Care,2008,11(5):613-619.
    [17]DU PLESSIS J,VANHEEL H,JANSSEN CE,et al.Activated intestinal macrophages in patients with cirrhosis release NO and IL-6that may disrupt intestinal barrier function[J].J Hepatol,2013,58(6):1125-1132.
    [18]TELTSCHIK Z,WIEST R,BEISNER J,et al.Intestinal bacterial translocation in rats with cirrhosis is related to compromised Paneth cell antimicrobial host defense[J].Hepatology,2012,55(4):1154-1163.
    [19]ARVANITI V,D'AMICO G,FEDE G,et al.Infections in patients with cirrhosis increase mortality four-fold and should be used in determining prognosis[J].Gastroenterology,2010,139(4):1246-1256,1256.e1-e5.
    [20]FRANCES R,MUNOZ C,ZAPATER P,et al.Bacterial DNA activates cell mediated immune response and nitric oxide overproduction in peritoneal macrophages from patients with cirrhosis and ascites[J].Gut,2004,53(6):860-864.
    [21]KIM BI,KIM HJ,PARK JH,et al.Increased intestinal permeability as a predictor of bacterial infections in patients with decompensated liver cirrhosis and hemorrhage[J].J Gastroenterol Hepatol,2011,26(3):550-557.
    [22] SHUKLA S,SHUKLA A,MEHBOOB S,et al.Meta-analysis:the effects of gut flora modulation using prebiotics,probiotics and synbiotics on minimal hepatic encephalopathy[J].Aliment Pharmacol Ther,2011,33(6):662-671.
    [23]ALBILLOS A,de LA HERA A,GONZALEZ M,et al.Increased lipopolysaccharide binding protein in cirrhotic patients with marked immune and hemodynamic derangement[J].Hepatology,2003,37(1):208-217.
    [24]SANDLER NG,KOH C,ROQUE A,et al.Host response to translocated microbial products predicts outcomes of patients with HBV or HCV infection[J].Gastroenterology,2011,141(4):1220-1230,1230.e1-e3.
    [25]SCHECHTER RB,LEMME EM,COELHO HS.Gastroesophageal reflux in cirrhotic patients with esophageal varices without endoscopic treatment[J].Arq Gastroenterol,2007,44(2):145-150.
    [26]ZHANG J,CUI PL,LV D,et al.Gastroesophageal reflux in cirrhotic patients without esophageal varices[J].World J Gastroenterol,2011,17(13):1753-1758.
    [27]SHARMA M,RAMESHBABU CS.Collateral pathways in portal hypertension[J].J Clin Exp Hepatol,2012,2(4):338-352.
    [28]KALAITZAKIS E,SADIK R,HOLST JJ,et al.Gut transit is associated with gastrointestinal symptoms and gut hormone profile in patients with cirrhosis[J].Clin Gastroenterol Hepatol,2009,7(3):346-352.
    [29]CHANDER ROLAND B,GARCIA-TSAO G,CIARLEGLIO MM,et al.Decompensated cirrhotics have slower intestinal transit times as compared with compensated cirrhotics and healthy controls[J].J Clin Gastroenterol,2013,47(10):888-893.
    [30]LAVIANO A,CANGIANO C,PREZIOSA I,et al.Plasma tryptophan levels and anorexia in liver cirrhosis[J].Int J Eat Disord,1997,21(2):181-186.
    [31]MIYAJIMA H,NOMURA M,MUGURUMA N,et al.Relationship among gastric motility,autonomic activity,and portal hemodynamics in patients with liver cirrhosis[J].J Gastroenterol Hepatol,2001,16(6):647-659.
    [32]GAIVORONSKII IV,TIKHONOVA LP,CHEPUR SV,et al.Intramural nervous apparatus of jejunum and rectum in experimental portal hypertension[J].Morfologiia,2004,125(3):36-40.
    [33]ZHU JZ,XU QZ,LIU QH.The changes of interstitial cell of Cajal in antrum of rats with liver cirrhosis[J].Chin J Gastroenter Hepatol,2005,14(6):618-620.(in Chinese)朱金照,许其增,刘庆宏.肝硬化大鼠胃窦Cajal间质细胞的变化[J].胃肠病学和肝病学杂志,2005,14(6):618-620.
    [34]USAMI A,MIZUKAMI Y,ONJI M.Abnormal gastric motility in liver cirrhosis:roles of secretin[J].Dig Dis Sci,1998,43(11):2392-2397.
    [35]TANG XD,FAN H,WAN P,et al.Multiple analysis on the gastric impetus associated factors in patients with liver cirrhosis[J].Chin JHepatol,2004,12(3):141-143.(in Chinese)唐晓丹,范红,万平,等.肝硬化患者胃动力多因素相关性研究[J].中华肝脏病杂志,2004,12(3):141-143.
  • 加载中
计量
  • 文章访问数:  2214
  • HTML全文浏览量:  31
  • PDF下载量:  498
  • 被引次数: 0
出版历程
  • 收稿日期:  2016-09-13
  • 出版日期:  2017-02-20
  • 分享
  • 用微信扫码二维码

    分享至好友和朋友圈

目录

    /

    返回文章
    返回