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Correlations of portal hypertensive gastropathy of hepatitis B cirrhosis with other factors.
Hepatobiliary Pancreat Dis Int. 2002 Nov; 1(4):527-31.HP

Abstract

OBJECTIVE

To study the clinical relations of portal hypertensive gastropathy (PHG) of hepatitis B cirrhosis to other factors.

METHODS

Three groups of subjects were studied prospectively at our hospital from March 2000 to March 2001: 159 hepatitis B cirrhotic patients with portal hypertension, 114 hepatitis B cirrhotic patients without portal hypertension, and 97 control subjects. Free portal vein pressure (FPP) was measured during surgery. Liver function was assessed by Pugh's modification of Child's criteria. The area of liver collagen fibrin was studied using color image analysis system. Esophageal varices were identified by Dagradi grading. Gastric varices were identified according to Northern Italian Endoscopic Council (NIEC) grading. Hypersplenism was assessed with the reduction of WBC, HGB and PLT. Hepatitis B virus in the gastric mucosa was detected by immunizing histochemistry. Helicobacter pylori (H. pylori) organisms were identified by rapid urease testing and/or examination of the stained biopsy specimens (haematoxylin and eosin). To analyze the correlation between these endoscopic signs at the gastric level and other factors.

RESULTS

The differences of FPP among the three groups (patients with grade I, II, and III gastropathy) were not significant. There was no correlation between Child-Pugh classification grading and the severity of gastropathy (P=0.153). The differences of the area of liver collagen fibrin among the three grade gastropathy were not statistically significant (P=0.801). There was a significant difference in the prevalence of severe PHG among grade I, II, III, IV and V esophageal varices (P<0.001). PHG was present in a similar percentage of patients with gastric varices compared with those without gastric varices (P=0.209). There was a significant difference in the severity between PHG and hypersplenism (P=0.003). Seven patients with PHG had no microscopic evidence of hepatitis B virus infection in the gastric wall. There was no correlation between Child-Pugh classification grading and infection of H. pylori (P=0.7491).

CONCLUSIONS

The most important element causing PHG is the increased portal pressure as a prerequisite. In addition, other factors may contribute to the development of PHG. PHG often occurs in patients with the presence of esophageal varices. There is a marked correlation between the severity of PHG and hypersplenism. Hepatitis B virus and H. pylori infection are unlikely to be involved in the pathogenesis of PHG. The development of PHG is less influenced either by the severity of liver disease (Child-Pugh grade) and cirrhosis or by the presence or non presence of gastric varices.

Authors+Show Affiliations

Pan WD
Department of General Surgery, Third Affiliated Hospital, Zhongshan University, Guangzhou 510630, China. panweidong1968@sohu.com
Xun RY
No affiliation info available
Chen YM
No affiliation info available

MeSH

AdultAgedEsophageal and Gastric VaricesFemaleHelicobacter InfectionsHelicobacter pyloriHepatitis BHumansHypersplenismHypertension, PortalLiverLiver CirrhosisMaleMiddle AgedPortal PressureRetrospective StudiesSeverity of Illness IndexStomach Diseases

Pub Type(s)

Journal Article

Language

eng

PubMed ID

14607680

Citation

Pan, Wei-Dong, et al. "Correlations of Portal Hypertensive Gastropathy of Hepatitis B Cirrhosis With Other Factors." Hepatobiliary & Pancreatic Diseases International : HBPD INT, vol. 1, no. 4, 2002, pp. 527-31.
Pan WD, Xun RY, Chen YM. Correlations of portal hypertensive gastropathy of hepatitis B cirrhosis with other factors. Hepatobiliary Pancreat Dis Int. 2002;1(4):527-31.
Pan, W. D., Xun, R. Y., & Chen, Y. M. (2002). Correlations of portal hypertensive gastropathy of hepatitis B cirrhosis with other factors. Hepatobiliary & Pancreatic Diseases International : HBPD INT, 1(4), 527-31.
Pan WD, Xun RY, Chen YM. Correlations of Portal Hypertensive Gastropathy of Hepatitis B Cirrhosis With Other Factors. Hepatobiliary Pancreat Dis Int. 2002;1(4):527-31. PubMed PMID: 14607680.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Correlations of portal hypertensive gastropathy of hepatitis B cirrhosis with other factors. AU - Pan,Wei-Dong, AU - Xun,Rui-Yun, AU - Chen,You-Ming, PY - 2003/11/11/pubmed PY - 2004/5/15/medline PY - 2003/11/11/entrez SP - 527 EP - 31 JF - Hepatobiliary & pancreatic diseases international : HBPD INT JO - Hepatobiliary Pancreat Dis Int VL - 1 IS - 4 N2 - OBJECTIVE: To study the clinical relations of portal hypertensive gastropathy (PHG) of hepatitis B cirrhosis to other factors. METHODS: Three groups of subjects were studied prospectively at our hospital from March 2000 to March 2001: 159 hepatitis B cirrhotic patients with portal hypertension, 114 hepatitis B cirrhotic patients without portal hypertension, and 97 control subjects. Free portal vein pressure (FPP) was measured during surgery. Liver function was assessed by Pugh's modification of Child's criteria. The area of liver collagen fibrin was studied using color image analysis system. Esophageal varices were identified by Dagradi grading. Gastric varices were identified according to Northern Italian Endoscopic Council (NIEC) grading. Hypersplenism was assessed with the reduction of WBC, HGB and PLT. Hepatitis B virus in the gastric mucosa was detected by immunizing histochemistry. Helicobacter pylori (H. pylori) organisms were identified by rapid urease testing and/or examination of the stained biopsy specimens (haematoxylin and eosin). To analyze the correlation between these endoscopic signs at the gastric level and other factors. RESULTS: The differences of FPP among the three groups (patients with grade I, II, and III gastropathy) were not significant. There was no correlation between Child-Pugh classification grading and the severity of gastropathy (P=0.153). The differences of the area of liver collagen fibrin among the three grade gastropathy were not statistically significant (P=0.801). There was a significant difference in the prevalence of severe PHG among grade I, II, III, IV and V esophageal varices (P<0.001). PHG was present in a similar percentage of patients with gastric varices compared with those without gastric varices (P=0.209). There was a significant difference in the severity between PHG and hypersplenism (P=0.003). Seven patients with PHG had no microscopic evidence of hepatitis B virus infection in the gastric wall. There was no correlation between Child-Pugh classification grading and infection of H. pylori (P=0.7491). CONCLUSIONS: The most important element causing PHG is the increased portal pressure as a prerequisite. In addition, other factors may contribute to the development of PHG. PHG often occurs in patients with the presence of esophageal varices. There is a marked correlation between the severity of PHG and hypersplenism. Hepatitis B virus and H. pylori infection are unlikely to be involved in the pathogenesis of PHG. The development of PHG is less influenced either by the severity of liver disease (Child-Pugh grade) and cirrhosis or by the presence or non presence of gastric varices. SN - 1499-3872 UR - https://www.unboundmedicine.com/medline/citation/14607680/Correlations_of_portal_hypertensive_gastropathy_of_hepatitis_B_cirrhosis_with_other_factors_ L2 - https://www.diseaseinfosearch.org/result/3332 DB - PRIME DP - Unbound Medicine ER -