门脉高压性胃病病理初步分析

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1、山西医科大学硕士学位论文门脉高压性胃病病理初步分析姓名：贺启贵申请学位级别：硕士专业：病理学指导教师：王全红2003.5.8门脉高压性胃病病理初步分析研究生：贺启贵导师：王全红教授主任医师[摘要]目的：探讨门脉高压性胃病(PortalhypertensiongastropathyPHG)的病理特点，分析对PHG的影响因素。材料方法：对85例乙型肝炎所致肝硬化PHG患者(PHG组)的胃粘膜活检组织进行幽门螺杆菌(HelicobacterpylonIIP)特殊染色，乙型肝炎病毒(HepatitisvirusBHBV)表面抗原(HBsAg)和核心抗原(HBc

2、Ag)免疫组织化学染色，光、电镜下观察；同时对PHG组患者肝组织进行HBsAg和HBcAg免疫组织化学染色。正常对照组40例胃粘膜活检组织光、电镜下观察，幽门螺杆菌特殊染色。结果：PHG组胃粘膜血管充血扩张、内皮细胞连接松散、粘膜上皮和间质水肿是PHG共同的病理改变。PHG组幽门螺杆菌感染率为77．8％(66／85)，部分病例壁细胞增生(24／85)，胃粘膜乙型肝炎病毒HBsAg和HBcAg免疫组织化学染色均为阴性，肝组织免疫组织化学染色，HBsAg阳性80(94％)例，HBcAg阳性83例(98％)：对照组幽门螺杆菌感染率为30％，PHG组显著高于l

3、出受曼盎蠢墨21蛆墨塑主茎焦蓬塞对照组(p

4、ropathy(PHG)，andtoanalysistheaffectingfactorsofPHG．Methods：Gastricmucosaltissuesfrom85patientswithPHG(PHGgroup)wereobservedunderlightandelectronmicroscopy,andimmunohistochemistryandspecialstainwerealsoperformed．Inthemeantime，allhepatictissuesfromthisgroupwereperformedimmunohisto

5、ehemistrystain．‘IncontrastwithPHGgroup，Gastricmucosaltissuesfrom40normalcases(controlgroup)wereobservedunderlightandelectronmicroscopy,specialstainwerealsoperformed．Results：VascularchangesofthegastricmucosawasthebasicpathologicalcharactersofPHG，andhelicobacterpylori(HP)infection

6、rateWaS77．8％inPHGgroup．oxynticcellswerehyperplasiainsomecases，immunohistochemistrystainof出重堡壁鑫茎29Q≥墨瑟主芏焦熊=墨HBsAgandHBcAgWasnegativeinthegastricmucosa,thepositiverateofHBsAgandHbcAgimmunohistochemistrystaininthehepatictissuesWas94％and98％，respectively．TheHPinfectionrateincontrolgr

7、oupwas30％，theHPinfectionrateinPHGgroupWasobviouslyhigherthanthoseincontrolgroup．Conclusion：PHGhasit’Sownrelativepathologicalcharacters，HPinfectionandhighacidstatemaybetwoimportantaffectingfactorsofPHG．ButtherewerenoevidencestoprovethathepatitisvirusB(HBV)hadjoinedinthecoUl'SeofP

8、HG．1Keywords]：Hypertension，portal；Gastropathy；H