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目的了解辽宁东部地区消化性溃疡(PU)的发病特点及变化情况,为PU的防治工作提供理论依据。方法采用回顾性研究方法,研究对象为2005年8月～2007年8月在辽宁东部丹东市中心医院接受胃镜检查的患者。对其中经内镜下分期诊断为PU活动期及愈合期的患者统计其临床资料,内容主要包括PU患者的性别、年龄、血型、职业、生活习惯、服药情况、14 C-尿素呼气试验、病理染色和细菌培养检测幽门螺杆菌(Hp)感染,其中任何一项检测阳性判断为Hp感染。结果共有9846例辽宁东部地区患者接受了胃镜检查,PU检出率为19.51%,十二指肠溃疡(DU)∶胃溃疡(GU)为1∶1.32,PU检出率以40～60岁检出率(41.2%)最高。所有患者在首次诊断PU时接受了Hp感染检测,其中916例(51.12%)患者Hp检测阳性。Hp检测阳性PU发病率明显高于阴性患者,对于Hp检测阳性的患者,DUHp感染率高于GU,差异有显著性(P<0.001)。GU中位年龄为52.5岁,DU中位年龄为66.1岁,GU比DU者平均年龄小13.6岁,差异有显著性(P<0.001)。GU患者中口服阿司匹林和/或非甾体(NSAIDs)类药物的患者比例高于DU,差异有显著性(P<0.001)。DU患者中吸烟、饮酒者的比例高于GU患者,但差异无显著性。结论辽宁东部地区Hp感染仍是PU患者最主要的病因,对于Hp检测阴性的PU患者,阿司匹林和/或NSAIDs类药物的应用是其主要病因,DU患者发病与年龄、Hp感染关系较GU更为密切,而GU的发病与NSAIDs类药物关系更为密切。
Objective To understand the characteristics and changes of peptic ulcer (PU) incidence in eastern Liaoning and provide a theoretical basis for the prevention and control of PU. Methods A retrospective study was conducted on patients who underwent gastroscopy in Dandong Central Hospital in eastern Liaoning from August 2005 to August 2007. Among them, the clinical data of patients with PU active stage and healing stage were diagnosed by endoscopic staging. The main contents include the gender, age, blood type, occupation, living habits, taking medication, 14 C-urea breath test, Pathological staining and bacterial culture detection of Helicobacter pylori (Hp) infection, any of which test positive for Hp infection. Results A total of 9846 cases of patients in eastern Liaoning Province underwent gastroscopy. The detection rate of PU was 19.51%, the rate of DU was 1: 1.32 for gastric ulcer (GU), and the detection rate of 40 to 60 years for PU Out rate (41.2%) highest. All patients underwent Hp infection at the time of the initial diagnosis of PU, with 916 (51.12%) patients having Hp positive. The incidence of Hp positive PU was significantly higher than that of negative patients. The prevalence of DUHp infection was higher in patients with positive Hp test (P <0.001). The median age of patients with GU was 52.5 years, the median DU was 66.1 years, and the average age of GU was 13.6 years younger than that of DU with a significant difference (P <0.001). The proportion of patients with oral aspirin and / or NSAIDs was higher in GU patients than in DU patients (P <0.001). The prevalence of smoking and drinking in DU patients was higher than that in GU patients, but the difference was not significant. Conclusions Hp infection in eastern Liaoning Province is still the most important cause of PU patients. Aspirin and / or NSAIDs are the main causes of PU in Hp negative patients. The incidence of DU patients is more related to age and Hp infection than GU Close, and the incidence of GU and NSAIDs drugs more closely related.