Microcirculative and Rheologic Features of Duodenal Ulcer Disease Against a Background of Chronic Hepatitis B

Purpose: An often combined course of duodenal ulcer disease (DUD) and chronic hepatitis B is obviously related to their blood supply as well as complicated pathogenetic links interrelated and intercaused. In this aspect microcirculatory and rheologic disorders are ones the important links of pathogenesis of DUD and chronic hepatitis. Methods: To investigate a state of microcirculation channel of the duodenum the morphometry method of A.A.Gutsola et al. has been used that is based on determination of common specific density of distributing microvessels in 1mm2 in bioptates. Rheologic features of blood in patients were studied based on determination of blood viscosity and electrophoretic motility of erythrocytes. Results: Results of study in 35 patients with DUD and chronic hepatitis B showed swelling of mucosal membranes of duodenum, reinforcement of macrophageal and leucocytes infiltration as well as desquamation of epithelial cells of ulcerous defect. Microcirculation channel in stroma of fibers and crypts is fulfilled with blood, vessels had extended gauge. Precapillaries were curved, filled with blood and had enlarged gauge, diameter by 1,49 times (22,3±1,30 mcm) (control 14,9 ± 0,80 mcm), capillary by 1,80 times (8,9 ± 0,42 mcm) (control 4,93 ± 0,13 mcm), postcapillaries by 1,43 times (27,0 ± 1,34 mcm) (control 18,8 ± 1,05 mcm). Parameters of blood viscosity were increasing on an average 48%, but electrophoretic motility of erythrocytes was decreasing by 35% as compared with controls. Conclusion: Thus, in patients with DUD and chronic hepatitis B I duodenal mucosa side by side with inflammatory destructive changes an uneven enlargement and seldom thinning of microcirculation channel were observed that evidenced an advancing vascular dystonia. At the same time mucosal capillaries were aneurysmatically enlarged and venous stasis contributes to developing tissual hypoxia. Disturbances of rheologic parameters of blood were likely to relate to microcirculation disorders in duodenal mucosa and functional disorders in the liver.

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