摘要
目的探讨胃微血管系统（ＧＭＳ）的扩张瘀血与门脉高压性胃病变及粘膜出血（ＰＨＧＭＨ）的关系．方法观察ＰＨＧＭＨ模型鼠（ｎ＝３４）的出血率、严重性分级及出血部位分布．形态测量法观察胃粘膜微血管直径（ＤＧＭＭ）、粘膜下小静脉管径比（ＰＳｍＶＤ）和粘膜下厚度（ＳｍＴ）改变，并分期观察与胃病变及粘膜出血的关系．结果①ＰＨＧＭＨ鼠的ＤＧＭＭ（４０１μｍ±３０μｍ），ＰＳｍＶＤ（０５０±００３），ＳｍＴ（１３９４μｍ±５９μｍ）以及出血率（９１２％）和严重性分级（ｇｒａｄｅ，２２７±０２０）均与对照有显著或非常显著差异（Ｐ＜００５及Ｐ＜００１）．②随门脉高压病程进展，上述各参数均呈增加趋势，尤其ＰＨＧＭＨⅡ鼠的ＰＳｍＶＤ（０５６±００４）、ＳｍＴ（１５５４μｍ±６６μｍ）及严重性分级（ｇｒａｄｅ，２６０±０２５）均与ＰＨＧＭＨⅠ鼠有显著差异（Ｐ＜００５）．同时出血率及严重性分级与ＳｍＴ和ＰＶＰ水平同步增加，而与ＤＧＭＭ和ＰＳｍＶＤ的增加不同步．③ＰＨＧＭＨ鼠出血部位分布以腺胃体部多见，并与对照有相似分布（２×ｋχ２＝３５０，Ｐ＞００５）．④出血部位粘膜表层上皮脱落缺?
IM Abstract:To investigate the effects of ectasias and congestion in the gastric miorovascular system (GMS) on portal hypertensive gastropathy and mucosal hemorrhage (PHG-MH).METHODS The occurrence rate, severity and sites of mucosal bleeding were obtained from the model of PHGMH induced by starvation in rats with liver cirrhosis and portal hypertension. The morphological mensurement was employed to observe the relationship between bleeding from the mucosa and changes in the parameters including the diameter of gastric mucosal microvessel (DGMM), the proportion of submucosal venules diameter (PSmVD) and the submucosal thickness (SmT), respectively.RESULTS ①DGMM (401μm±30μm), PSmVD (050±003), SmT (1394μm±59μm) and occurrence rate (912%) and severity (grade, 227±020) were significantly increased in PHGMH rats (P<005 and P<001, vs control). ②All above parameters were increased gradually with the development of portal hypertension, especially PSmVD (056±004), SmT (1554μm±66μm) and severity (grade, 260±025) in PHGMHⅡ rats were increased more significantly than that in PHGMHⅠ(P<005). ③Bleeding sites in PHGMH rats were similar to that in control group and were distributed mainly in the corpus mucosa. ④The erosion of superficial epithelium and small necrosis of mucous membrane were more often observed in PHGMH rats, especially in rats with 4 grade bleeding. ⑤DGMM in the corpus mucosa was slightly larger than that in the antrum mucosa with no significant difference (P>005). ⑥There were positive relations between PSmVD and SmT, and DGMM.CONCLUSION Ectasias and congestion in GMS is an important factor for the course of PHGMH. PSmVD and SmT were closely related to development of PHG-MH, and the presence of increased arteriovenous anatomosis in the gastric submucosa may play an important role in GMS changes and devel
关键词
门脉高压症
并发症
胃疾病
胃肠出血
hypertension, portal/pathology
stomach diseases/complication
gastrointestinal hemorrhage/pathology
gastric mucosa/pathology
