根除幽门螺杆菌治疗后消化性溃疡的流行病学研究附30993例胃镜资料分析

Epidemiological survey of peptic ulcer after the eradicative treatment of helicobacter pylori: endoscopic analysis of 30993 cases

目的了解近20年来幽门螺杆菌(Hp)根除治疗后消化性溃疡(Pu)的发病情况及变化特点。方法回顾性分析我院24年来胃镜检查消化性溃疡的临床资料,以1985年1月为分界,之前为未开展根除Hp治疗消化性溃疡期,之后为开展根除Hp治疗消化性溃疡期。结果1985～1994年和1995～2003年消化性溃疡检出率分别为14.92%和14.80%,与1979～1984年的17.13%比较显著下降(P<0.05)。1985～1994年和1995～2003年消化性溃疡的平均发病年龄分别为(40.64±11.65)岁和(44.72±13.55)岁,分别高于1979～1984年的(38.13±13.20)岁,(P<0.05);>60岁的老年患者1995年后发病显著增高(P<0.01)。1985～1994年和1995～2003年的男女之比为3.73∶1和2.38∶1,显著低于1979～1984年的7.72∶1(P<0.05)。24年来发病均以1～4月为高峰,6～9月最低。结论开展根除Hp治疗后消化性溃疡的发病率下降、发病年龄增大、老年人患病率增加、男女之比下降、发病季节无明显改变。

Objective To investigate the prevalence and characteristic alterations of the peptic ulcer after the eradicative treatment of helicobacter pylori (Hp) in recent 20 years.Methods To retrospectively analyse the clinical data of peptic ulcer of gastroscopy collected from our hospital in recent 24 years,1979-1984 was the period undeveloped the eradicative treatment of HP and 1985-2003 was the period developed the eradicative treatment of HP.Results The detecting rates of peptic ulcer of gastroscopy during the period 1985-1994 and 1995-2003 were 14.92% and 14.80%, respectively, which were significantly lower than that ( 17.13%) during the period 1979-1984 (P<0.05).The average age of patients with peptic ulcer increased gradually and remarkablely after the eradicative treatment of Hp. The male and female ratio was 7.72∶1 before the eradicative treatment of Hp during perid 1979-1984, but 3.73∶1 and 2.38:1 were found after the eradication treatment of Hp during perid 1985-1994 and 1995-2003 (P<0.05). The morbidity of peptic ulcer in aged (over 60) increased significantly since 1995. Episodic attacks occurred mostly in winter and spring and least in summer.Conclusion After the eradicative treatment of Hp, the total morbidity of peptic ulcer and the male and female ratio decreased significantly , the morbidity in aged increased remarkablely, and the age of patients with it also increased, but the morbidity in seasons did not change.