中国人溃疡病流行状况及其治疗依从性

目的　获取中国人溃疡病的流行状况并观察溃疡病人对医嘱的依从性及其对疗效的影响。方法　采用同时性、前瞻性方法 ,调查溃疡病 11983例 ,了解不同性别、年龄、职业、文化程度患者溃疡病的发病情况和幽门螺杆菌 (Hp)的感染率 ,并就病人对医嘱的依从性及溃疡病的疗效、复发情况进行调查。结果　消化性溃疡病的年发病率根据标化人口统计约为 0 84‰ ,男女患病比为 3 6∶1;管理人员发病率最高 ,达 0 40 % ;高峰年龄组为 30～ 49岁 ;十二指肠球部溃疡与胃溃疡的发病比为1 9∶1;溃疡直径 <10mm占 80 %以上 ;Hp感染阳性率为 73 8% ;溃疡年复发率为 6 8% ,Hp阳性对溃疡的复发影响显著 (P <0 0 1)。溃疡病人对医嘱的依从率仅为 47 1% ;依从者的溃疡治愈率达97 4% ,而不依从者仅为 5 8 8%。结论　消化性溃疡病仍是我国的一种多发疾病 ,对我国劳动力资源危害严重 ;Hp阳性溃疡病的比例与发达国家接近 ;溃疡病人对医嘱的依从性较低且其对疗效影响显著。     

消化性溃疡病诊断与治疗规范建议(2008,黄山)

消化性溃疡病是最常见的消化系疾病之一,随着消化内镜检查的普及、H2受体拮抗剂(H2-receptor antagonist,H2-RA)和质子泵抑制剂(proton pump inhibitots,PPI)的问世,非甾体类抗炎药(non-steroidal anti-inflammatory drugs,NSAID)的广泛应用及对幽门螺杆菌(Helicobacterpylori,Hp.pylori)在消化性溃疡病发生中作用的认识,使近二十年来对消化性溃疡病的诊断、治疗发生了巨大的变革,尤其是PPI及根除幽门螺杆菌在消化性溃疡病治疗中的应用,降低了消化性溃疡病的发病率和各种并发症发生率,使患者的生活质量得到很大提高.我国幅员辽阔,对消化性溃疡病的治疗还存在较大的差异.     

谈谈治疗消化性溃疡病的几个错误观点

消化性溃疡病(PuD)是一种常见病，发病高峰年龄胃溃疡(Gu)为40～60岁，十二指肠溃疡(Du)为40～50岁。据近年来的流行病学调查，发现老年人PuD的发病率呈逐年增加，如有作者报告，老年PuD人数占溃疡病人数的百分比，由1948～1960年的6．7％，至1990～1998年已上升为38％。可在年轻人中的PuD发病率有下降趋势，故PuD不单是年轻人的好发病，也是老年人的常见病了。近40多年来，     

消化性溃疡病的流行病学和自然史

1 流行病学消化性溃疡病是一种常见的慢性消化系统疾病。它的发病率很高,约有5%～10%的人口在其一生中的某一时期罹患此病。在我国,有关全人口的发病率     

老年人消化性溃疡

一、消化性溃疡病是老年人的常见病消化性溃疡病(Pepticulcerdisease简称PUD)为一种在胃肠粘膜层穿透到粘膜肌层的溃疡,常发生在胃肠有胃酸和胃蛋白酶可达的部位。好发于年轻人,发病高峰年龄胃溃疡(gastriculcer简称Gu)为40～60岁,十二指肠溃疡(duodenalulcer简称Du)为20～50岁。据近年来的流行病学调查,PUD的发病率在年轻人有所下降,但老年人PUD的发病率呈逐年增加,新加坡老年PUD人数占溃疡病人数的百分比,在1948～1960年为6.7%,1960～1968年为17%,1990～1998年达到38%。日本资料显示,1958～1977的20年中,每5年为一组,60岁以上老年人…     

老年消化性溃疡

随着人口老龄化迅速发展，老年消化性溃疡的发病率有增高趋势，特别是老年胃溃疡发病率逐年上升，其临床表现不典型，并发症多且严重，应引起重视。近年来，溃疡病的诊断和治疗措施已有较大进展，特简要介绍于后。１溃疡病的年龄、性别与发病率消化性溃疡病是常见病，各家...     

消化性溃疡病诊断与治疗规范建议（解读）

消化性溃疡病是消化系统的常见多发病,以胃、十二指肠最为常见.在过去的近30年中,随着强效抑酸剂以及根除幽门螺杆菌治疗的应用,消化性溃疡病的发病率和并发症发生率有了很大改善,但目前仍然是最常见的消化系疾病之一.尤其近年来随着非甾类抗炎药物（NSAIDS）和低剂量阿司匹林越来越广泛的应用,我们认识到消化性溃疡仍是一个重要的临床问题.中华消化杂志编委会于2008年组织国内相关领域专家,讨论拟定了我国《消化性溃疡病诊断与治疗规范建议》[1],得到国内临床医师的广泛认同.     

无痛性消化性溃疡78例临床分析

消化性溃疡(peptic ulcer，pu)常常以反复发作的节律性上腹疼痛为特征。献报告消化性溃疡病发病率在5％～10％．而尸检中约为3％～24％。可见相当一部分消化性溃疡患无症状，这就给早期诊断造成了一定困难。本组收集消化性溃疡796例．其中无痛性消化性溃疡患78例，占病例总数的9.8％。本通过分析无痛性消化性溃疡临床特点，以引起临床医师的注意．     

消化性溃疡复发原因及中西医对策

一、消化性溃疡复发原因。近年来，随着大量新型抑制胃酸药物问世，溃疡病近期治愈已不是难事，但溃疡愈合时间日益缩短并未解决溃疡病的另一难题——溃疡的反复发作。大量研究表明溃疡病自然复发率为每月8．5％，1年的自然复发率达90％，迄今为止，使用任何制酸药均不能改变溃疡病的自然病程，停药后复发率大致相当。     

无痛性消化性溃疡78例临床分析

消化性溃疡(peptic ulcer,pu)常常以反复发作的节律性上腹疼痛为特征。文献报告消化性溃疡病发病率在5%～10%,而尸检中约为3%～24%。可见相当一部分消化性溃疡患者无症状,这就给早期诊断造成了一定困难。本组收集消化性溃疡796例,其中无痛性消化性溃疡患者78例,占病例总数的9.8%。本文通过分析无痛性消化性溃疡临床特点,以引起临床医师的注意.     

21310例十二指肠溃疡流行病学分析

目的探讨十二指肠溃疡的流行病学特点。方法对南宁市17家医院1992—1997年经胃镜检查诊断为十二指肠溃疡的21310例患者资料进行回顾性分析。结果①从行胃镜检查的104121例患者中检出十二指肠溃疡21310例,检出率为20．47％,占检出的消化性溃疡87．87％。②十二指肠溃疡中,男16002例、女5308例,男性发病人数多于女性（P〈0．01）。③中青年是十二指肠溃疡的高发年龄,30～39岁年龄段是检出的高峰。④十二指肠球部溃疡的易发部位依次为前壁（47．16％,11662处）、大弯（24．90％,6159处）、小弯（16．67％,4123处）、后壁（11．27％,2787处）。霜斑样溃疡在十二指肠球后发生率较高。⑤十二指肠溃疡发病与季节有一定关系,检出率最高的是冬春季。结论十二指肠溃疡患者男性多于女性;中青年为十二指肠溃疡高发人群,球部溃疡以前壁最多见;霜斑样溃疡在十二指肠球后较常见;十二指肠溃疡冬春季检出率高于夏秋季。     

A retrospective study of ABI and TBI during the healing of ulcer among diabetic patients

ObjectiveTo assess the role of ABI and TBI in the detection of ulcer wounds among diabetic patients.MethodsA retrospective approach is used to enroll 192 diabetic patients to detect their ulcer wounds using ABI and TBI index. HbA1c and lipid profile were other important variables in determining the efficacy of screening test. Frequency analysis and Pearson Correlation were used to analyze the data through SPSS.FindingsThe results have shown that 57.1% male and 42.9% female were treated in <0.60 ABI group; 67.4% male and 32.6% female were treated in 0.60–0.90 ABI group; 65.9% male and 34.1% female were treated in 0.90–1.30 ABI group; and 63.8% male and 36.2% female were treated in >1.30 ABI group. The correlation showed insignificant association between ABI and ulcer outcomes, but significant association between TBI and ulcer outcomes at 5% level of significance.ConclusionThe study concluded that ABI should be based on standardized normal values to be used as an effective biomarker in screening diabetic foot ulcer patients.     

Is the AIMS65 score useful in predicting outcomes in peptic ulcer bleeding?

AIM:To evaluate the applicability of AIMS65 scores in predicting outcomes of peptic ulcer bleeding.METHODS:This was a retrospective study in a single center between January 2006 and December 2011.We enrolled 522 patients with upper gastrointestinal haemorrhage who visited the emergency room.Highrisk patients were regarded as those who had rebleeding within 30 d from the first endoscopy as well as those who died within 30 d of visiting the Emergency room.A total of 149 patients with peptic ulcer bleeding were analysed,and the AIMS65 score was used to retrospectively predict the high-risk patients.RESULTS:A total of 149 patients with peptic ulcer bleeding were analysed.The poor outcome group comprised 28 patients[male:23(82.1%)vs female:5(10.7%)]while the good outcome group included 121patients[male:93(76.9%)vs female:28(23.1%)].The mean age in each group was not significantly different.The mean serum albumin levels in the poor outcome group were slightly lower than those in the good outcome group(P=0.072).For the prediction of poor outcome,the AIMS65 score had a sensitivity of35.5%(95%CI:27.0-44.8)and a specificity of 82.1%(95%CI:63.1-93.9)at a score of 0.The AIMS65 score was insufficient for predicting outcomes in peptic ulcer bleeding(area under curve=0.571;95%CI:0.49-0.65).CONCLUSION:The AIMS65 score may therefore not be suitable for predicting clinical outcomes in peptic ulcer bleeding.Low albumin levels may be a risk factor associated with high mortality in peptic ulcer bleeding.     

Helicobacter pylori seroprevalence in hepatitis C virus positive patients with cirrhosis

BACKGROUND/AIMS: Liver cirrhosis is a significant cause of death in Italy and one of the most frequent causes of hospitalization. Acute peptic ulcer and upper gastrointestinal bleeding reportedly occur in over one-third of cirrhotic patients. Since Helicobacter pylori (H. pylori) infection strongly correlates with peptic ulcer, we sought to ascertain the prevalence of H. pylori infection in cirrhotic patients. METHODS: In a case-control study, we examined 254 consecutive patients (127 male and 127 female, age range 30-82 years) suffering from hepatitis C virus (HCV)-related cirrhosis and 463 sex- and age-matched patients admitted to the Department of Emergency Care of our hospital (254 male, 209 female, age range 30-79 years) resident in the same area. RESULTS: Antibodies to H. pylori were present in 226/254 (89%) cirrhotic patients and in 275/463 (59%) controls (p<0.0001). The difference was significant both in males and in females. CONCLUSIONS: The very high prevalence of H. pylori infection may explain the frequent occurrence of gastroduodenal ulcer in cirrhotic patients and may possibly determine the prognosis of those who are also infected with HCV.     

上消化道疾病9910例胃镜检查结果分析

目的：分析胃镜检查思考各种上消化道疾病的发病率、年龄分布、性别比例、幽门螺杆菌(Hp)感染及其关系。方法：对9910例患者用OLYMPUS纤维胃镜、电子胃镜进行上消化道疾病检查，同时进行HP及病理切片检查。结果：疾病检出炎症＞溃疡＞癌症；男性发病多于女性；Hp与炎症、溃疡有相关性，与胃癌相关性明显低于炎症及溃疡，残胃炎与Hp感染无正相关性。结论：上消化道疾病男性发病多于女性，上消化道疾病检出炎症＞溃疡＞癌症，Hp感染与炎症、溃疡关系密切。     

老年消化性溃疡230例临床与内镜特点探讨

目的：研究老年消化性溃疡的临床特征和内镜特点.方法：分析2009年12月～2010年8月收治的230例老年消化性溃疡患者,并分析这230例老年消化性溃疡患者的临床资料.结果：230例老年消化性溃疡患者中,其中男性患者140例,占60.87%,女性患者90例,占39.13%;有不良嗜好（如吸烟,喝酒）者共60例,其中男性43例,占71.67%,女性17例,占28.33%;将230例患者分为有不良嗜好组和无不良嗜好组两组,其中不良嗜好组幽门梗阻、上消化道出血、巨大溃疡有39例,发生率为65%;无不良嗜好组幽门梗阻、上消化道出血、巨大溃疡有35例,占20.59%,不良嗜好组幽门梗阻、上消化道出血、巨大溃疡发生率明显高于无不良嗜好组.经统计学分析有统计学差异.结论：老年消化性溃疡男性发生率比女性高,消化性溃疡并发症幽门梗阻、上消化道出血、巨大溃疡跟不良嗜好之间有一定的联系.     

性激素对大鼠实验性十二指肠溃疡愈合与胃酸分泌的影响

目的 研究性激素对十二指肠溃疡（ＤＵ）的愈合及对胃酸分泌的影响。方法 用冰醋酸局部涂抹的方法建立大鼠ＤＵ模型，第４天起隔日分别注射雌二醇、孕酮、丙酸睾酮，对照组注射生理盐水。术后第２３天测定溃疡面积、胃液量和胃酸等。结果 术后７２小时各例大鼠都形成了穿通性溃疡，雌雄大鼠溃疡面积无显著差异。术后第２３天，雌性对照组、雄性雌二醇组、雄性孕酮组溃疡面积显著小于雄性对照组；雌性对照组、雄性雌二醇组胃液量和     

A single nocturnal dose of famotidine for the treatment of duodenal ulcer: evaluation of efficacy and safety

The efficacy and safety of a single nocturnal dose of famotidine (40 mg) was evaluated in 30 consecutive patients of duodenal ulcer (DU). Three patients were lost for follow-up and therefore were excluded. The mean age of remaining 27 patients was 34.3 (+/- 9.9) years and male to female ratio was 8:1. The mean size of the DU was 1.21 (+/- 0.79) cm. After a 4-week therapy all patients showed significant improvement and repeat endoscopy in 24 out of 27 patients (89%, 95% confidence interval; 78% to 100%) showed healed ulcer. Clinical assessment of pain relief at 4-week showed significant drop in the mean score of baseline daytime (from 1.85 to 0.13) and baseline nocturnal pain (from 1.70 to 0.10) (p less than 0.0001 and less than 0.0001, respectively). Also shown was the significant decrease in the mean gastrointestinal symptoms score from 5.89 at baseline to only 0.89 at 4-week (p less than 0.0001). Despite that all those who failed to show ulcer healing at 4-week were smokers, logistic regression analysis could not identify smoking or any other risk factors as adverse predictors of ulcer healing. None of the patients experienced significant side effects or adverse reactions. We conclude, that a single nocturnal dose of famotidine is a practical, highly effective and safe approach for the management of DU.     

The incidence in Copenhagen County of gastric and duodenal ulcers in the same patient.

This study represents a prospective, epidemiologic study dealing with patients from a geographically well-defined area of Denmark who had both a gastric and a duodenal ulcer diagnosed during the years 1963-1968. The average annual incidence of new cases was 1.6 per 10,000 inhabitants aged 15 years and over, which is a higher incidence than any registered so far, especially compared with the frequencies of solitary gastric and duodenal ulcers. The incidence was 20 times as high as might be expected if the occurrence of the syndrome was incidental only. In both sexes the incidence increased with age in a manner similar to that seen in solitary gastric ulcers. The male:female ratio was 2.2:1. The incidence of cases in which both ulcers appeared simultaneously at the first 'positive' diagnostic examination was 0.7 per 10,000 at risk. Certain observations indicate, however, that even in those cases, the two ulcer components have arisen at different times.