本文报告2例疱疹性食管炎所致急性上消化道出血。2例均系60岁以上女性。例1因呕血黑便入院,发病前有胸骨下轻度间歇性烧灼感数年,无恶心、吞咽困难及吞咽疼痛。例2因过敏性血管炎和急性肾功能衰竭住院,起病前1周曾出现紫癜或斑丘疹,住院第9天起出现吞咽疼痛,继则发生呕血。内窥镜检查见食管远端2/3处有斑点样损害和活动性出血。细胞学及活检均未发现念珠菌,而呈现多形核细胞和单纯疱疹病毒感染的核内嗜伊红包涵体。可培养到疱疹病毒。患者食管下端压力降低,括约肌松弛,蠕动紊乱或消失。尸检和病例报告证实,单纯疱疹病毒感染为食管溃疡的常见病因,特别是在免疫抑制、恶性血液病者。疱疹性食管炎也常并发于肾移植、烧伤、溃疡性结肠炎、皮质类固醇治疗和其他化疗、放射治疗的病 This article reports 2 cases of herpes esophagitis caused by acute upper gastrointestinal bleeding. 2 cases were all over the age of 60 women. Example 1 due to hematemesis was admitted to hospital, before the onset of mild sternal intermittent burning sensation for several years, no nausea, swallowing difficulties and swallowing pain. Example 2 hospitalized for allergic vasculitis and acute renal failure, purpura or rash occurred 1 week before onset, swallowing pain on the 9th day after hospitalization, followed by hematemesis. Endoscopic examination of esophageal distal 2/3 spot-like damage and active bleeding. No cytology and biopsy were found in Candida, which showed polymorphonuclear cells and herpes simplex virus infection in the nuclear eosinophiles. Herpes virus can be cultivated. Patients lower esophageal pressure, sphincter relaxation, peristaltic disorder or disappear. Autopsy and case reports confirm that herpes simplex virus infection is a common cause of esophageal ulcers, especially in immunosuppressed, hematologic malignancies. Herpes esophagitis is also often complicated by kidney transplantation, burns, ulcerative colitis, corticosteroid therapy and other chemotherapy and radiation therapies