类风湿关节炎合并特发性门脉高压症1例报道
|
摘要
特发性门脉高压症(idiopathic portal hypertension, IPH)是以窦前性门脉压增高为特征性表现的综合征。目前发病机制不明,可能与免疫、感染、遗传变异等有关。临床表现为脾大、食管静脉曲张、反复上消化道出血,而肝功能正常或基本正常。降低门脉高压预防消化道出血是治疗关键。近年来免疫在发病机制中的作用越来越引起人们重视,本文将1例类风湿关节炎合并特发性门脉高压症的病例报道如下。
Idiopathic portal hypertension(IPH) is a syndrome with a characteristic of increasing sinus pressure. The current pathogenesis is unknown, and may be related to immunity, infection, genetic variation and so on. The clinical manifestations are splenomegaly, esophageal varices, repeated upper gastrointestinal bleeding, and normal or basically normal liver function. Lowering portal hypertension to prevent gastrointestinal bleeding is the key to treatment. In recent years, the role of immunity in the pathogenesis has attracted more and more attention. This article reported one case of rheumatoid arthritis complicated with idiopathic portal hypertension as follows.
Idiopathic portal hypertension(IPH) is a syndrome with a characteristic of increasing sinus pressure. The current pathogenesis is unknown, and may be related to immunity, infection, genetic variation and so on. The clinical manifestations are splenomegaly, esophageal varices, repeated upper gastrointestinal bleeding, and normal or basically normal liver function. Lowering portal hypertension to prevent gastrointestinal bleeding is the key to treatment. In recent years, the role of immunity in the pathogenesis has attracted more and more attention. This article reported one case of rheumatoid arthritis complicated with idiopathic portal hypertension as follows.
引文
[1] RIGGIO O,GIOIA S,PENTASSUGLIO I,et al.Idiopathic noncirrhotic portal hypertension:current perspectives [J].Hepat Med,2016,8:81-88.DOI:10.2147/HMER.S85544.
[2] 韩麦,徐伟民,马安林.特发性门脉高压的诊断和临床处理[J].中国肝脏病杂志(电子版),2016,8(2):1-4.DOI:10.3969/j.issn.1674-7380.2016.02.001.HAN M,XU W M,MA A L.Idiopathic portal hypertension:diagnosis and clinical management [J].Chinese Journal of Liver Disease,2016,8(2):1-4.DOI:10.3969/j.issn.1674-7380.2016.02.001.
[3] INAGAKI H,NONAMI T,KAWAGOE T,et al.Idiopathic portal hypertension associated with systemic lupus erythematosus [J].J Gastroenterol,2000,35(3):235-239.
[4] KOGAWA H,MIGITA K,ITO M,et al.Idiopathic portal hypertension associated with systemic sclerosis and Sj?gren’s syndrome [J].Clin Rheumatol,2005,24(5):544-547.DOI:10.1007/s10067-005-1084-y.
[5] 王莉,袁孟彪,韩炜,等.免疫因素在特发性门脉高压症发病机制中的作用[J].山东大学学报(医学版),2006,44(6):583-585,589.WANG L,YUAN M B,HAN W,et al.Immune mechanism in pathogenesis of idiopathic portal hypertension [J].Journal of Shandong University (Health Science),2006,44(6):583-585,589.
[6] KATHAYAT R,PANDEY G K,MALHOTRA V,et al.Rabbit model of non-cirrhotic portal fibrosis with repeated immunosensitization by rabbit splenic extract [J].J Gastroenterol Hepatol,2002,17 (12):1312-1316.
[7] TANAKA T,SUGAWARA Y,KOKUDO N.The current clinical aspects of idiopathic portal hypertension [J].Intractable Rare Dis Res,2013,2(3):94-97.DOI:10.5582/irdr.2013.v2.3.94.
[8] OKUDAIRA M,OHBU M,OKUDA K.Idiopathic portal hypertension and its pathology [J].Semin Liver Dis,2002,22(1):59-72.DOI:10.1055/s-2002-23207.
[9] SIRAMOLPIWAT S,SEIJO S,MIQUEL R,et al.Idiopathic portal hypertension:natural history and long-term outcome [J].Hepatology,2014,59(6):2276-2285.DOI:10.1002/hep.26904.
[2] 韩麦,徐伟民,马安林.特发性门脉高压的诊断和临床处理[J].中国肝脏病杂志(电子版),2016,8(2):1-4.DOI:10.3969/j.issn.1674-7380.2016.02.001.HAN M,XU W M,MA A L.Idiopathic portal hypertension:diagnosis and clinical management [J].Chinese Journal of Liver Disease,2016,8(2):1-4.DOI:10.3969/j.issn.1674-7380.2016.02.001.
[3] INAGAKI H,NONAMI T,KAWAGOE T,et al.Idiopathic portal hypertension associated with systemic lupus erythematosus [J].J Gastroenterol,2000,35(3):235-239.
[4] KOGAWA H,MIGITA K,ITO M,et al.Idiopathic portal hypertension associated with systemic sclerosis and Sj?gren’s syndrome [J].Clin Rheumatol,2005,24(5):544-547.DOI:10.1007/s10067-005-1084-y.
[5] 王莉,袁孟彪,韩炜,等.免疫因素在特发性门脉高压症发病机制中的作用[J].山东大学学报(医学版),2006,44(6):583-585,589.WANG L,YUAN M B,HAN W,et al.Immune mechanism in pathogenesis of idiopathic portal hypertension [J].Journal of Shandong University (Health Science),2006,44(6):583-585,589.
[6] KATHAYAT R,PANDEY G K,MALHOTRA V,et al.Rabbit model of non-cirrhotic portal fibrosis with repeated immunosensitization by rabbit splenic extract [J].J Gastroenterol Hepatol,2002,17 (12):1312-1316.
[7] TANAKA T,SUGAWARA Y,KOKUDO N.The current clinical aspects of idiopathic portal hypertension [J].Intractable Rare Dis Res,2013,2(3):94-97.DOI:10.5582/irdr.2013.v2.3.94.
[8] OKUDAIRA M,OHBU M,OKUDA K.Idiopathic portal hypertension and its pathology [J].Semin Liver Dis,2002,22(1):59-72.DOI:10.1055/s-2002-23207.
[9] SIRAMOLPIWAT S,SEIJO S,MIQUEL R,et al.Idiopathic portal hypertension:natural history and long-term outcome [J].Hepatology,2014,59(6):2276-2285.DOI:10.1002/hep.26904.