Etiopathogenesis of Gastric Ulcer in Liver Cirrhosis

Ichiro Tsuruta
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Abstract

Liver cirrhosis is frequently complicated by gastric ulceration and many studies have been published regarding the mechanism of this association. The major factors possibly responsible include the influence of hepatic dysfunction on the acid and pepsin contents of gastric juice, insufficient hepatic inactivation of gastric juice secretion stimulating factors, reduced resistance of the gastric mucosa due to malnutrition, disturbed gastric mucosal circulation due to elevated portal pressure, and interactions between gastrointestinal hormones. The exact mechanism is still unclear. In a previous paper, we reported on the high incidence of gastric ulcer in patients with liver cirrhosis" . This time the relationship between liver cirrhosis and gastric ulceration was investigated by determining the kinetics of gastric juice secretion, the levels of gastrointestinal hormones, the condition of the gastric mucosa, the site of gastric ulceration, and the presence of esophageal varices. In addition, histopathological changes of gastric wall vessels, particularly arteriosclerosis and venosclerosis of the gastric wall, were investigated in autopsy cases.
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肝硬化胃溃疡的发病机制
肝硬化经常并发胃溃疡,关于这种关联的机制已经发表了许多研究。可能的主要因素包括肝功能障碍对胃液酸和胃蛋白酶含量的影响、胃液分泌刺激因子在肝脏失活不足、营养不良导致胃黏膜抵抗力下降、门静脉压力升高导致胃黏膜循环紊乱以及胃肠激素之间的相互作用。确切的机制尚不清楚。在之前的一篇论文中,我们报道了肝硬化患者胃溃疡的高发。这次通过测定胃液分泌动力学、胃肠激素水平、胃粘膜状况、胃溃疡部位和食管静脉曲张的存在来研究肝硬化和胃溃疡之间的关系。此外,在尸检病例中,我们还研究了胃壁血管的组织病理学变化,特别是胃壁动脉硬化和静脉硬化。
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